New and Updated Topics
Enhanced Content
The following topics have been improved to make them easier to read, navigate and understand. They have been informed by, or include, the experiences of people who are facing that health issue.
- Circumcision: This enhanced topic helps readers understand the pros and cons of circumcision. The topic emphasizes that in most cases, circumcision is elective surgery, which means there is no medical reason for it. New content includes research that supports this focus.
- COPD (Chronic Obstructive Pulmonary Disease): This topic now includes four patient stories that address such issues as quitting smoking, exercising when you have COPD, finding support, and dealing with depression.
- Schizophrenia: This topic has been rewritten in "plain language" that is easy to understand. Our plain-language content has a reading level of 6th- to 8th-grade or lower. The topic contains new content on schizophrenia and pregnancy, schizophrenia and the caregiver, schizophrenia and the hospital, getting support, stigma, substance abuse and mental health, exercise, sleeping better, and helping someone deal with negative symptoms. There are new sections on "Recovery" and "Family and Friends."
Healthwise is committed to writing topics in "plain language" that is easy to understand. The Topic Overview sections of the following topics have been revised for plain language, written at a reading level of 6th- to 8th-grade or lower. In upcoming releases, Healthwise will deliver more Topic Overviews written in this style.
- Addison's Disease
- Aortic Valve Regurgitation
- Bowel Obstruction
- Cleft Palate
- Color Blindness
- Cosmetic Surgery and Procedures
- Cushing’s Syndrome
- Dupuytren's Disease
- Environmental Illness
- Growth and Development, Ages 1 to 12 Months
- Guillain-Barré Syndrome
- Hantavirus Pulmonary Syndrome (HPS)
- Hearing Loss
- Hemophilia
- Hiatal Hernia
- Hirschsprung's Disease
- Hypertrophic Cardiomyopathy
- Intussusception
- Kawasaki Disease
- Mad Cow Disease
- Melatonin
- Ménière's Disease
- Mitral Valve Stenosis
- Necrotizing Enterocolitis
- Necrotizing Fasciitis (Flesh-Eating Bacteria)
- Non-Hodgkin's Lymphoma
- Organ Transplant
- Outpatient Services
- Phenylketonuria (PKU)
- Physical Therapy
- Prescription Medicines
- Pyloric Stenosis
- Rabies
- Reye Syndrome
- Rubella (German Measles)
- Stuttering
- Supraventricular Tachycardia
- Tay-Sachs Disease
- Temper Tantrums
- Umbilical Hernia in Children
- Venous Skin Ulcer
- Von Willebrand's Disease
Enhanced Decision Points
All Healthwise Decision Points have been revised and restructured to provide an enhanced shared decision making process and new user interface. Healthwise has developed the interactive Decision Points using international standards such as the International Patient Decision Aid Standards, external consultants, and internal medical and content research and expertise. All Decision Points have been reviewed and have been transitioned to the new format.
The existing document structure has been changed to include sections presented in a tabbed format. The structure of the Decision Point highlights the decision making process. An example of the new tab interface is shown below.
Get the Facts
The Get the Facts section includes Key Points to Remember and FAQs.
Key points are the core of a decision. They capture the most important information in the Decision Point and present it in an easy-to-understand format. Often, key points summarize compelling medical information, offer a concise look at risk versus benefit, explain possible short-term and long-term outcomes, cite expert recommendations, or even offer common-sense advice. The remaining sections in the Decision Point support the statements made in the key points.
The FAQs section presents medical information in question-and-answer format. This section includes medical facts about the options presented in the Decision Point, such as:
- What’s involved in each option.
- How well each option works.
- How factors such as stage of disease, health history, and age might affect the decision.
- What the clinical guidelines recommend.
Compare Options
The Compare Options section offers a side-by-side comparison table that allows a consumer to directly compare the benefits and risks of each option. Personal stories about people who chose each option are included.
Your Feelings
The Your Feelings section helps users think about and express their feelings and preferences about the options. An example of the new interactive slider is shown below.
Your Decision
The Your Decision section asks which option a user is leaning toward, after having learned the key medical facts and thought about what matters to them.
Quiz Yourself
The Quiz Yourselfsection lets consumers check their knowledge of the facts. They can also express how confident they feel about making the decision and record any other concerns they may have. The Decide what’s next section is shown below. This enables a user to record an assessment of their readiness to make a decision.
Your Summary
The Your Summary section collects the personalized information entered throughout the Decision Point. Users can use this summary to review their choices and even make a printout to take to a next doctor’s visit. Their doctor can use the summary page to see how well a patient understood the medical facts, what their personal feelings are about the decision, and which way they’re leaning. Consumers can also share the printout with anyone else whom they want to involve in the decision.
Decision Point Title Changes
We have revised the titles of the Decision Points to bring the key words closer to the start of the title and to make the titles as clear, short, and easy to read as possible. The new title format also reveals the content’s focus on decision making. These changes will help users more readily notice Decision Points in search results lists and quickly know what a given Decision Point is about and how it might be helpful.
Here is the list of our enhanced Decision Points:
New Title
Old Title
Should I have surgery for a ruptured Achilles tendon?
Should I have surgery for an anterior cruciate ligament (ACL) injury?
Should I see my doctor for acne?
Should I take isotretinoin for severe acne?
Should I take antibiotics for acute bronchitis?
Should my child take stimulant medications for ADHD?
Should I take allergy shots (immunotherapy) for allergic rhinitis and allergic asthma?
Should I have allergy shots for allergies to insect stings?
Should I take medications to treat Alzheimer's disease?
Alzheimer's or other dementia: Should I move my relative into long-term care?
Should I put my relative with Alzheimer's or other dementia in a nursing home?
Should I replace my aortic valve with a mechanical or tissue valve?
Should I have surgery to replace my aortic valve?
Should I have knee replacement surgery?
Should I take anticoagulants to prevent stroke?
Should I try cardioversion for atrial fibrillation?
Should I have an autopsy done on my loved one?
Should I treat my child's bed-wetting?
Should I schedule a doctor visit to discuss my child's bed-wetting?
Should my baby have a probing procedure to open a blocked tear duct?
Should I bank blood before surgery?
Should I have breast reconstruction after a mastectomy?
Should I have breast-conserving surgery or a mastectomy to treat early-stage breast cancer?
Should I use chemotherapy for early-stage breast cancer?
What should I do if I'm at high risk for breast cancer?
Should I have a gene test for breast and ovarian cancer?
Should I breast-feed my baby?
Should I have surgery for bunions?
Should I have surgery for carpal tunnel syndrome?
Should I have cataract surgery?
Should I have my son circumcised?
Which test should I have to screen for colorectal cancer?
Should I use complementary medicine?
Should I stop taking my depression medicine?
Should I take medications to treat depression?
Should I take antidepressants while I'm pregnant?
Should my child take medications to treat depression?
Should I get an insulin pump?
I have diabetes. Should I get pregnant now?
Should I have surgery for Dupuytren's disease?
Should I treat dysfunctional uterine bleeding with hormone therapy?
Should I give my child antibiotics for an ear infection?
Should I have my child treated for chronic fluid behind the eardrum?
Should I receive artificial hydration and nutrition?
Should I receive CPR and mechanical ventilation?
Should I stop kidney dialysis?
Should I stop life-prolonging treatment?
Should I have a hysterectomy and oophorectomy to treat endometriosis?
Should I use hormone therapy to treat endometriosis?
Should I have surgery or take medicine to treat benign prostatic hyperplasia (BPH)?
Should I use medication or watchful waiting to treat benign prostatic hyperplasia (BPH)?
Should I use phosphodiesterase-5 inhibitors for erection problems?
Should I use injections for erection problems?
Should I have infertility testing?
Should I get a flu shot?
Should I take antiviral medicine for the flu?
Should I have surgery to treat gallstone attacks?
Should I use medications or surgery to treat gastroesophageal reflux disease (GERD)?
Should I treat inherited hair loss with medication?
Should I have surgery for hammer, claw, or mallet toes?
Should I have image tests to evaluate my headaches?
Should I take medicine to prevent migraine headaches?
Should I take prescription drugs for tension headaches?
Should I get a hearing aid?
Should I take low-dose aspirin to prevent heart attack or stroke?
Should I have an angiogram to test for coronary artery disease?
Should I have angioplasty for stable angina?
Should I have coronary artery bypass graft (CABG) surgery?
Should I have a coronary calcium scan to check for heart disease?
Should I get an implantable cardioverter-defibrillator (ICD) for heart failure?
Should I get a pacemaker for heart failure?
Should I have regularly scheduled or on-demand clotting factor replacement therapy for hemophilia?
Which treatment for hemorrhoids is right for me?
Should I use antiviral therapy for chronic hepatitis B?
Should I be tested for hepatitis B and C?
Should I take antiviral therapy for hepatitis C?
Should I have surgery for a herniated disc?
Should I take medicine for high blood pressure?
Should I take statins for high cholesterol?
Should I start antiretroviral medicines for HIV infection even though I have no symptoms?
Should my daughter get the HPV vaccine?
Should I use antithyroid medication or radioactive iodine to treat hyperthyroidism?
Should I use estrogen replacement therapy (ERT) after a hysterectomy and oophorectomy?
Should I have my ovaries removed when I have a hysterectomy?
Should I have a tubal procedure or in vitro fertilization for tubal infertility?
Should I have infertility treatment?
Should I have surgery for inguinal hernia now, or should I wait?
Should I take sleeping pills for insomnia?
Should I have tests for irritable bowel syndrome (IBS)?
What type of dialysis should I have?
Should I use extracorporeal shock wave lithotripsy (ESWL) for my kidney stones?
Should I have magnetic resonance imaging (MRI) for low back pain?
Should I have spinal manipulative therapy for low back pain?
Should I have an MRI or arthroscopy to diagnose a possible torn meniscus?
Should I have surgery for my torn meniscus?
Should I use hormone replacement therapy (HRT)?
Should I have medical, surgical, or no treatment to complete a miscarriage?
Should I consider a multifetal pregnancy reduction?
Should I have disease-modifying therapy for multiple sclerosis?
Should I take oral antifungal medication to treat a fungal nail infection?
Should I have laser surgery for nearsightedness?
Should I have surgery for obesity?
Should I use prescription medicines to treat obesity?
Should I take medicines to treat obsessive-compulsive disorder (OCD)?
Should I have a sleep study to diagnose obstructive sleep apnea?
Should I have hip replacement surgery?
Should I have a dual-energy X-ray absorptiometry (DEXA) test to diagnose osteoporosis?
Should I take bisphosphonate medications for osteoporosis?
Should I have my ovaries removed to prevent ovarian cancer?
Should I take medications to treat panic disorder?
What follow-up will I need if my Pap test shows minor cell changes?
Should I have surgery for pelvic organ prolapse?
Should I have surgery for peripheral arterial disease?
Should I have surgery for plantar fasciitis?
Should I try an SSRI for premenstrual syndrome (PMS)?
Should I bank my baby's umbilical cord blood?
Should I have an amniocentesis?
Should I have an early fetal ultrasound?
Should I use epidural anesthesia during childbirth?
Should I have chorionic villus sampling (CVS)?
Should I have the maternal serum triple or quadruple test (triple or quad screen)?
Should I have a VBAC trial of labor after a previous cesarean?
Should I have a prostate-specific antigen (PSA) test to screen for prostate cancer?
Should I have radiation therapy or a prostatectomy for localized prostate cancer?
Should I take medicine to quit smoking?
Should I have rotator cuff surgery?
Should I (or my child) have surgery for scoliosis?
Should I have surgery for sinusitis?
Should I have surgery to treat obstructive sleep apnea?
Should I have surgery for spinal stenosis?
Which treatment for stress incontinence is right for me?
Should I have carotid endarterectomy for stroke or transient ischemic attack (TIA)?
Should I put my loved one who has had a stroke in a nursing home?
Should I have surgery to treat tennis elbow?
Which treatment should I have for stage I nonseminoma testicular cancer?
Which treatment should I have for stage I seminoma testicular cancer?
Should I have surgery for temporomandibular disorder?
Should my child have a tonsillectomy?
Should I have surgery to cure ulcerative colitis?
Should my child have surgery for an umbilical hernia?
Should I have surgery to treat uterine fibroids?
Should I have uterine fibroid embolization for uterine fibroids?
Should I use GnRH-a therapy to treat uterine fibroids?
Should I self-treat vaginal yeast infection with a nonprescription medication?
Should I have surgical procedure for varicose veins?
Should I treat warts or plantar warts?
Should I use over-the-counter diet aids?
Should I have a wisdom tooth removed?
Deleted Decision Points
During our analysis of the existing Decision Points, we identified a few for which the new decision point format is not appropriate. In those cases, we took the content from the Decision Point and either used it to create a new topic or revised it to fit into an existing Knowledgebase topic. In two cases, we decided that the content was not needed in the Knowledgebase at this time and deleted it.
These Decision Points were deleted:
- Should I be vaccinated against smallpox?
- How can I make informed decisions about my extremely premature infant?
- Should I consider adoption as an alternative to infertility treatment?
- Should I plan to have an episiotomy?
- Should I use nicotine replacement therapy to quit smoking?
- Which birth control method should I use?
Enhanced Symptom Topics
All Healthwise Symptom Topics have been revised and restructured to include a new, interactive Check Your Symptoms tool. This Adobe Flash tool replaces the previous Emergencies and Check Your Symptoms sections. In each topic, the content from those sections has been combined into an integrated, interactive question format. To support the technical change, the underlying medical logic and content have been thoroughly reviewed and updated.
Emergency conditions are now presented in questions. These help the user recognize critical health problems more reliably. The topics also contain new emergency care recommendations. Where appropriate, these recommendations include first-aid instructions that users can follow while they wait for help to arrive. Examples include:
- Instructions to take aspirin in the case of heart attack symptoms.
- Directions for stopping bleeding.
- Directions for performing the Heimlich maneuver if someone is choking.
We have also added specialized treatment recommendations for poisoning, abuse, and dental issues to relevant topics.
Age and gender questions have been added to each topic. This demographic information ensures that only relevant questions are asked. For example, the gender question acts as a filter so that male users do not get questions about pregnancy or menstruation. We also use questions about certain symptoms to filter nonessential questions. For instance, users who answer that they do not have a fever are not asked more detailed questions about fever, such as “How high is your temperature?�
The medical logic for each topic has been reviewed and updated to provide the most streamlined triage experience possible. Questions are asked only one time, and nonessential questions are filtered out. The most severe symptoms are assessed first. As a user answers each question, our tool saves the user’s responses. As the user meets specific criteria based on the responses, the user gets a recommendation about what level of care to seek. Users who do not need professional care are given home treatment advice.
In order of urgency, the care levels are:
- Call 911 (Blue).
- Seek Care Now (Red).
- Seek Care Today (Yellow).
- Make an Appointment (Black).
- Try Home Treatment (Green).
The Yellow, Black, and Green care recommendations now link to the topic’s Home Treatment and Related Information sections.
We have rewritten all questions in plain language that is easy to understand. Questions contain only one concept, which makes them easier to answer. And they are now standardized across symptom topics to provide consistent medical logic. Supporting information that helps users answer the questions, such as definitions, has also been rewritten in plain language and standardized across topics.
Here is the list of our enhanced Symptom topics:
- Abdominal Pain, Age 11 and Younger
- Abdominal Pain, Age 12 and Older
- Abnormal Vaginal Bleeding
- Alcohol and Drug Problems
- Allergic Reaction
- Anger, Hostility, and Violent Behavior
- Animal and Human Bites
- Anxiety
- Arm Injuries
- Arm Problems, Noninjury
- Back Problems and Injuries
- Blisters
- Body Piercing Problems
- Breast Problems
- Bruises and Blood Spots Under the Skin
- Burns
- Burns to the Eye
- Change in Heartbeat
- Chest Problems
- Cold Temperature Exposure
- Confusion, Memory Loss, and Altered Alertness
- Constipation, Age 11 and Younger
- Constipation, Age 12 and Older
- Coughs, Age 12 and Older
- Crying, Age 3 and Younger
- Cuts
- Dehydration
- Diabetes-Related High and Low Blood Sugar Levels
- Diaper Rash
- Diarrhea, Age 11 and Younger
- Diarrhea, Age 12 and Older
- Dizziness: Lightheadedness and Vertigo
- Domestic Abuse
- Ear Canal Problems (Swimmer's Ear)
- Ear Problems and Injuries, Age 11 and Younger
- Ear Problems and Injuries, Age 12 and Older
- Earwax
- Elbow Injuries
- Elbow Problems, Noninjury
- Exposure to Sexually Transmitted Diseases
- Eye Injuries
- Eye Problems, Noninjury
- Facial Injuries
- Facial Problems, Noninjury
- Feeling Depressed
- Female Genital Problems
- Fever, Age 3 and Younger
- Fever, Age 4 and Older
- Fever Seizures
- Finger, Hand, and Wrist Injuries
- Finger, Hand, and Wrist Problems, Noninjury
- Fishhook Injuries
- Gas, Bloating, and Burping
- Groin Problems and Injuries
- Head Injury, Age 3 and Younger
- Head Injury, Age 4 and Older
- Headaches
- Heartburn
- Heat-Related Illnesses
- Hip Injuries, Age 11 and Younger
- Hip Injuries, Age 12 and Older
- Hip Problems, Age 11 and Younger
- Hip Problems, Age 12 and Older
- Hyperventilation
- Insect Bites and Stings and Spider Bites
- Knee Problems and Injuries
- Leg Injuries
- Leg Problems, Noninjury
- Male Genital Problems and Injuries
- Marine Stings and Scrapes
- Menstrual Cramps
- Missed or Irregular Periods
- Mouth and Dental Injuries
- Mouth Problems, Noninjury
- Nail Problems and Injuries
- Nausea and Vomiting, Age 4 and Older
- Neck Problems and Injuries
- Nervous System Problems
- Nosebleeds
- Nose Injuries
- Objects in the Ear
- Objects in the Eye
- Objects in the Nose
- Physical Abuse
- Pinkeye
- Poisoning
- Postoperative Problems
- Pregnancy-Related Problems
- Problems After Delivery of Your Baby
- Puncture Wounds
- Rash, Age 11 and Younger
- Rash, Age 12 and Older
- Rectal Problems
- Respiratory Problems, Age 11 and Younger
- Respiratory Problems, Age 12 and Older
- Ringing in the Ears (Tinnitus)
- Scalp Problems
- Scrapes
- Seizures
- Sexual Abuse or Assault (Rape)
- Shoulder Problems and Injuries
- Skin Changes
- Sleep Problems, Age 12 and Older
- Snake and Lizard Bites
- Sore Throat
- Suicidal Thoughts or Threats
- Sunburn
- Swallowed Objects
- Swelling
- Swollen Glands and Other Lumps Under the Skin
- Tattoo Problems
- Tick Bites
- Toe, Foot, and Ankle Injuries
- Toe, Foot, and Ankle Problems, Noninjury
- Toothache and Gum Problems
- Urinary Problems and Injuries, Age 11 and Younger
- Urinary Problems and Injuries, Age 12 and Older
- Vomiting, Age 3 and Younger
- Weakness and Fatigue
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