Watchful waiting
Encyclopedia
Watchful waiting 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, active surveillance and masterly inactivity. The term masterly inactivity is also used in nonmedical contexts.
A distinction can be drawn between watchful waiting and medical observation, but some sources equate the terms. Usually, watchful waiting is an outpatient process and it may have a duration of months or years. In contrast, medical observation usually is an inpatient process, often involving frequent or even continuous monitoring, and may have a duration of hours or days.
Watchful waiting is often recommended for many common illnesses such as ear infections
; because the majority of cases resolve spontaneously, antibiotic
s 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 involve:
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.
(US) does not support observation services for over 48 hours).
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
problem in which time is allowed to pass before medical intervention or therapy is used. During this time, repeated testing
Medical test
A diagnostic test is any kind of medical test performed to aid in the diagnosis or detection of disease. For example:* to diagnose diseases, and preferably sub-classify it regarding, for example, severity and treatability...
may be performed.
Related terms include expectant management, active surveillance and masterly inactivity. The term masterly inactivity is also used in nonmedical contexts.
A distinction can be drawn between watchful waiting and medical observation, but some sources equate the terms. Usually, watchful waiting is an outpatient process and it may have a duration of months or years. In contrast, medical observation usually is an inpatient process, often involving frequent or even continuous monitoring, and may have a duration of hours or days.
Uses
Often watchful waiting is recommended in situations with a high likelihood of self-resolution, in situations where there is high uncertainty concerning the diagnosis, and in situations where the risks of intervention or therapy may outweigh the benefits.Watchful waiting is often recommended for many common illnesses such as ear infections
Otitis media
Otitis media is inflammation of the middle ear, or a middle ear infection.It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache,...
; because the majority of cases resolve spontaneously, antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...
s will often be prescribed only after several days of symptoms. It is also a strategy frequently used in surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
prior to a possible operation, when it is possible for a symptom (for example abdominal pain
Abdominal pain
Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of abdominal pain can be difficult, because many diseases can result in this symptom. Abdominal pain is a common problem...
) to either improve naturally or become worse.
Other examples involve:
- the diagnosis and treatment of benign prostatic hypertrophy
- Odd behaviors in infants.
- depressionDepression (mood)Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...
. - otitis mediaOtitis mediaOtitis media is inflammation of the middle ear, or a middle ear infection.It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache,...
- prostate cancerProstate cancerProstate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize from the prostate to other parts of the body, particularly...
Watchful waiting
In many applications, a key component of watchful waiting is the use of an explicit decision treeDecision tree
A decision tree is a decision support tool that uses a tree-like graph or model of decisions and their possible consequences, including chance event outcomes, resource costs, and utility. It is one way to display an algorithm. Decision trees are commonly used in operations research, specifically...
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 only kept in observation for 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, MedicareMedicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
(US) does not support observation services for over 48 hours).