ASCP Expands 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 30 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 routinely test for community gastrointestinal stool pathogens in hospitalized patients who develop diarrhea after day three of hospitalization.
2. Do not repeat Hepatitis C virus antibody testing in patients with a previous positive Hepatitis C virus (HCV) test. Instead, order Hepatitis C viral load testing for assessment of active versus resolved infection.
3. Do not perform a hypercoagulable workup in patients taking direct factor Xa or direct thrombin inhibitors 26.
4. Don’t use plasma catecholamines to evaluate a patient for pheochromocytoma or paraganglioma; instead use plasma free metanephrines or urinary fractionated metanephrines.
5. Do not routinely order broad respiratory pathogen panels unless the result will affect patient management.

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.

“As ASCP continues to expand our recommendations, we expect to see increasing higher quality, appropriate care with lower costs, and more effective use of our medical laboratory resources and personnel,” said Dr. Hilborne. “Choosing Wisely aims to encourage clinician and patient conversations across all disciplines of medicine. ASCP’s work focuses on highlighting potentially unnecessary and sometimes harmful care in pathology and laboratory medicine.”

“ASCP is appreciative of all members of the effective test utilization/lab stewardship community who have contributed to this effort, making ASCP the most prolific Choosing Wisely contributing organization,” he added.

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.

Richard J. Baron, MD, President and CEO of the ABIM Foundation, commended the Society for its ongoing leadership on the issue of unnecessary care. “ASCP has been one of our most stalwart partners in the Choosing Wisely campaign,” he said. “Without committed relationships such as this one, the ABIM Foundation would not have been able to achieve the success it has in spreading awareness about and spurring action on overuse in health care.”

More than 80 specialty medical societies have joined the Choosing Wisely campaign since its inception in April 2012. To date, more than 600 recommendations regarding tests and procedures to question have been released as part of the campaign, and the specialty societies have undertaken considerable efforts to share the recommendations with their collective memberships.

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

Other articles in the October 2019 ePolicy News:

ASCP Delegation Meets with FDA on LDT Oversight
Fix PAMA, Don’t Change Laboratory Date of Service Rule, ASCP Urges CMS
Meaningful Participation Sought Under the QPP for Pathologists in 2020
ASCP Opposes E/M Proposal in Medicare Physician Fee Schedule
CDC Coordinates Investigation, Offers Healthcare Provider Resources Regarding Lung Disease Associated with Vaping
Choosing Wisely Champions Recognized for Reducing Unnecessary Testing

To read more articles from ePolicy News click here.

For more information regarding ASCP's advocacy initiatives and policy positions, please contact ASCP's Center for Public Policy at (202) 408-1110.

ASCP ePolicy News is supported by an unrestricted grant from Hologic.