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

medical Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...

problem in which time is allowed to pass before medical intervention or therapy is used. During this time, repeated

testing An examination (exam or evaluation) or test is an educational assessment intended to measure a test-taker's knowledge, skill, aptitude, physical fitness, or classification in many other topics (e.g., beliefs). A test may be administered verba ...

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 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 health care ...

process and may have a duration of months or years. In contrast,

medical observation Medical observation is a medical service aimed at continued care of selected patients, usually for a period of 6 to 24 (sometimes more) hours, to determine their need for inpatient admission. This service is usually provided in emergency departme ...

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 health car ...

process, often involving frequent or even continuous

monitoring Monitoring may refer to: Science and technology Biology and healthcare * Monitoring (medicine), the observation of a disease, condition or one or several medical parameters over time * Baby monitoring * Biomonitoring, of toxic chemical compounds, ...

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 or 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 fluid bui ...

in children;American Academy of Pediatrics
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 bacterial infections, and antibiotic medications are widely used in the treatment and prevention of ...

s will often be prescribed only after several days of symptoms. It is also a strategy frequently used in

surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

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. Common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome. About 15% of people have a m ...

) 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, inability to urinate, or loss o ...

* depression *

otitis media Otitis media is a group of 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 pulling at the ear, ...

inguinal hernia An inguinal 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 absent in about a third ...

* odd behaviors in

infant An infant or baby is the very young offspring of human beings. ''Infant'' (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is a formal or specialised synonym for the common term ''baby''. The terms may also be used to ...

s *

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 ...

* non-symptomatic

kidney stone Kidney stone disease, also known as nephrolithiasis or urolithiasis, is a crystallopathy where a solid piece of material (kidney stone) develops in the urinary tract. Kidney stones typically form in the kidney and leave the body in the urine s ...

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

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External links