ASCP Releases Expanded List of Commonly Used Tests Physicians and Patients Should Question

Laboratory Community’s Contributions to Effective Test Utilization Makes
ASCP the Most Prolific Contributor to ABIM Foundation’s Choosing Wisely Campaign

ASCP has released an updated list of recommendations for laboratory tests that are commonly ordered but not always appropriate in pathology and laboratory medicine as part of the Choosing Wisely campaign, an initiative of the ABIM Foundation. The new list of five targeted, evidence-based recommendations expands ASCP’s existing list to 35 recommendations and is designed to support conversations between patients and physicians about what care is really necessary.

ASCP’s new Choosing Wisely recommendations include:

1. Do not generally use swabs to collect specimens for microbiology cultures on specimens from the operating room. For optimal recovery of microbes, tissue or fluid samples obtained in the operating room should be submitted, when available and adequate.
2. Avoid Thyroid Stimulating Hormone (TSH) screening in annual well-visits for asymptomatic adults, regardless of age.
3. Don’t perform urine cytology for routine hematuria investigation.
4. Do not order a Type & Crossmatch for patients undergoing procedures that have minimal anticipated blood loss, historically low fraction of transfusion use, and a low transfusion index (ratio of transfused units to patients).
5. Do not monitor anti-platelet agent inhibition of platelet activity using platelet function or genetic testing.

The expanded recommendations were developed under the leadership of Lee H. Hilborne, MD, MPH, FASCP, DLM(ASCP)^CM, Chair of ASCP’s Effective Test Utilization Steering Committee and a Past President of ASCP. Subject matter and test utilization experts across the fields of pathology and laboratory medicine were included in this process for their expertise and guidance.

“We are very pleased to continue to see ASCP at the forefront of initiatives to guide appropriate test utilization, recognizing ASCP’s role in guiding higher quality care, lower costs, and more effective use of laboratory resources,” says Dr. Hilborne.  “We are pleased to welcome lab leaders from ASM and ASCLS to our team.  Choosing Wisely encourages clinician and patient conversations across all disciplines of medicine. ASCP’s work focuses specifically on potentially unnecessary and occasionally harmful care in pathology and laboratory medicine.”

Examples of inappropriate and over-utilized tests are frequent throughout both anatomic and clinical pathology and laboratory medicine. The medical laboratory tests targeted in the new

ASCP recommendations were selected because they are tests that are commonly performed; there is evidence that the test either offers no benefit or is harmful; use of the test is costly and it does not provide higher quality patient care; and eliminating it or changing to another test is within the control of the clinician.

Learn more about ASCP’s involvement in Choosing Wisely here.