• Nao Hanaki, Jun Miyata, Yoshie Yamada, and Takashi Shiga.
• Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
• J Emerg Med. 2023 Mar 1; 64 (3): 371379371-379.

BackgroundThe overuse of diagnostic and therapeutic modalities has become an issue in the field of emergency medicine. The health care system of Japan aims to provide the most appropriate quality and quantity of care at the right price, while focusing on patient value. The Choosing Wisely® campaign was launched in Japan and other countries.ObjectiveIn this article, recommendations were discussed to improve the field of emergency medicine based on the state of the Japanese health care system.MethodsThe modified Delphi method, a consensus-building method, was used in this study. The final recommendations were developed by a working group of 20 medical professionals, students, and patients, consisting of members of the emergency physician electronic mailing list.ResultsFrom the 80 candidates recommended and excessive actions gathered, nine recommendations were formulated after two Delphi rounds. The recommendations included the suppression of excessive behavior and the implementation of appropriate medical treatment, like rapid pain relief and the application of ultrasonography during central venous catheter placement.ConclusionsThis study formulated recommendations to improve the field of Japanese emergency medicine, based on the feedback of patients and health care professionals. The nine recommendations will be helpful for all people involved in emergency care in Japan because they have the potential to prevent the overuse of diagnostic and therapeutic modalities, while maintaining the appropriate quality of patient care.Copyright © 2023 Elsevier Inc. All rights reserved.

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