Watchful waiting

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 ear infections in children; because the majority of cases resolve spontaneously, antibiotics will often be prescribed only after several days of symptoms. It is also a strategy frequently used in surgery prior to a possible operation, when it is possible for a symptom (for example abdominal pain) to either improve naturally or become worse.

Other examples include:

• the diagnosis and treatment of benign prostatic hyperplasia
• depression
• otitis media
• inguinal hernia
• odd behaviors in infants
• non-symptomatic kidney stones
• gender dysphoria in children prior to the onset of puberty

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. 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).

References

References

1. (7 April 2020). "Pestana's Surgery Notes". Kaplan Test Prep.
2. "Definition of expectant management - NCI Dictionary of Cancer Terms".
3. "Watchful Waiting or Active Surveillance for Prostate Cancer".
4. (September 1997). "Management of asymptomatic aortic stenosis: masterly inactivity but cat-like observation". Heart.
5. (1952-08-18). "Masterly Inactivity - TIME".
6. "Australian Prostate Cancer Website".
7. "Prostate cancer guide - MayoClinic.com".
8. (January 1980). "Definition of watchful waiting - NCI Dictionary of Cancer Terms".
9. [http://www.aap.org/healthtopics/earinfections.cfm American Academy of Pediatrics] {{webarchive. link. (June 14, 2007)
10. (April 2006). "Is watchful waiting a reasonable approach for men with minimally symptomatic inguinal hernia?". CMAJ.
11. (January 2007). "Factors associated with primary care clinicians' choice of a watchful waiting approach to managing depression". Psychiatr Serv.
12. (August 2006). "Watchful waiting for acute otitis media: are parents and physicians ready?". Pediatrics.
13. (August 2008). "The Treatment of Adolescent Transsexuals: Changing Insights". The Journal of Sexual Medicine.
14. (March 2012). "Clinical Management of Gender Dysphoria in Children and Adolescents: The Dutch Approach". Journal of Sexuality.
15. (November 1992). "Management of small abdominal aortic aneurysms. Early surgery vs watchful waiting". JAMA.
16. "Gundersen Lutheran - What is Outpatient Observation?".