Watchful waiting (also watch and wait or WAW) is an approach to a

medical Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...

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'' (especially

active surveillance of prostate cancer Active surveillance is a management option for localized prostate cancer that can be offered to appropriate patients who would also be candidates for aggressive local therapies (surgery and radiotherapy), with the intent to intervene if the disease ...

), 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 A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other healt ...

process and may have a duration of months or years. In contrast, medical observation is usually an

inpatient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other heal ...

process, often involving frequent or even continuous monitoring and may have a duration of hours or days.

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 Otitis is a general term for inflammation in ear or ear infection, inner ear infection, middle ear infection of the ear, in both humans and other animals. When infection is present, it may be viral or bacterial. When inflammation is present due to ...

in children; because the majority of cases resolve spontaneously,

antibiotic An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting pathogenic bacteria, bacterial infections, and antibiotic medications are widely used in the therapy ...

s will often be prescribed only after several days of

symptoms Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

. It is also a strategy frequently used in

surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

prior to a possible operation, when it is possible for a symptom (for example

abdominal pain Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given th ...

) to either improve naturally or become worse. Other examples include: * the diagnosis and treatment of

benign prostatic hyperplasia Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, urinary retention, inability t ...

* depression *

otitis media Otitis media is a group of Inflammation, inflammatory diseases of the middle ear. One of the two main types is acute otitis media (AOM), an infection of rapid onset that usually presents with ear pain. In young children this may result in pullin ...

inguinal hernia An inguinal hernia or groin hernia is a hernia (protrusion) of abdominal cavity contents through the inguinal canal. Symptoms, which may include pain or discomfort especially with or following coughing, exercise, or bowel movements, are absen ...

* odd behaviors in infants * non-symptomatic

kidney stone Kidney stone disease (known as nephrolithiasis, renal calculus disease, or urolithiasis) is a crystallopathy and occurs when there are too many minerals in the urine and not enough liquid or hydration. This imbalance causes tiny pieces of cr ...

s *

gender dysphoria in children Gender dysphoria (GD) in children, also known as gender incongruence (GI) of childhood, is a formal diagnosis for distress (gender dysphoria) caused by incongruence between assigned sex and gender identity in some pre-pubescent transgender a ...

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 A decision tree is a decision support system, decision support recursive partitioning structure that uses a Tree (graph theory), tree-like Causal model, model of decisions and their possible consequences, including probability, chance event ou ...

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

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External links