Watchful waiting
Watchful waiting |
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Watchful waiting (also watch and wait or WAW) is an approach to a medical problem in which time is allowed to pass before medical intervention or therapy is used. During this time, repeated testing may be performed.
Related terms include expectant management,[1][2] active surveillance (especially active surveillance of prostate cancer),[3] and masterly inactivity.[4] The term masterly inactivity is also used in nonmedical contexts.[5]
A distinction can be drawn between watchful waiting and medical observation,
Medical uses
Often watchful waiting is recommended in situations with a high likelihood of self-resolution if there is high uncertainty concerning the diagnosis, and the risks of intervention or therapy may outweigh the benefits.
Watchful waiting is often recommended for many common illnesses such as
Other examples include:
- the diagnosis and treatment of benign prostatic hyperplasia
- depression[11]
- otitis media[12]
- inguinal hernia
- odd behaviors in infants
- non-symptomatic kidney stones
- gender dysphoria in children prior to the onset of puberty[13][14]
Process
Watchful waiting
In many applications, a key component of watchful waiting is the use of an explicit decision tree or other protocol to ensure a timely transition from watchful waiting to another form of management, as needed.[15] This is particularly common in the post-surgical management of cancer survivors, in whom cancer recurrence is a significant concern.
Medical observation
Usually, patients in observation, according to hospital policy, are kept in observation for only 24 or 48 hours before they will be discharged or admitted as an inpatient. Insurance can play a role in how "observation" is defined (for example, US Medicare does not support observation services for over 48 hours).[16]
See also
References
- ISBN 978-1506254340.
Signs of a fracture affecting the base of the skull include raccoon eyes, rhinorrhea, and otorrhea or ecchymosis behind the ear. Expectant management is the rule. From our perspective, the significance of a base of the skull fracture is that it indicates that the patient sustained very severe head trauma
- ^ "Definition of expectant management - NCI Dictionary of Cancer Terms".
- ^ "Watchful Waiting or Active Surveillance for Prostate Cancer".
- PMID 9391278.
- ^ "Masterly Inactivity - TIME". Time. 1952-08-18. Archived from the original on January 10, 2008. Retrieved 2010-05-27.
- ^ "Australian Prostate Cancer Website".
- ^ "Prostate cancer guide - MayoClinic.com".
- ^ "Definition of watchful waiting - NCI Dictionary of Cancer Terms". January 1980.
- ^ American Academy of Pediatrics Archived June 14, 2007, at the Wayback Machine
- PMID 16636325.
- PMID 17215415.
- S2CID 7808557.
- .
- .
- PMID 1433687.
- ^ "Gundersen Lutheran - What is Outpatient Observation?".