ASCP to Collaborate with ASCLS and ASM in Choosing Wisely Campaign

June 10, 2020

ABIM Foundation Taps ASCP to Assist Laboratory Organizations in
Developing Recommendations to Reduce Test Overuse

By request from the ABIM Foundation, ASCP has collaborated in working with the American Society for Clinical Laboratory Science (ASCLS) and the American Society for Microbiology (ASM) as they participate in the Choosing Wisely initiative. The Choosing Wisely campaign, launched by the ABIM Foundation in 2012, aims to reduce test overuse and encourage clinicians and patients to question which tests are really necessary. 

The ASCLS today released its first set of recommendations, reviewed by ASCP, of which laboratory tests should be questioned.

  • Do not order a factor V Leiden (FVL) mutation assay as the initial test to identify a congenital cause for a thrombotic event. First, order a phenotypic activated protein C resistance (APCR) ratio assay.
  • Do not use herpes simplex virus (HSV) polymerase chain reaction (PCR) testing for genital HSV infection screening in adults and adolescents. Real-time HSV PCR testing should only be used to confirm herpes diagnosis in patients with suspected herpes.
  • Do not transfuse red blood cells as the sole intervention for expansion of circulatory volume unless deemed necessary for patients experiencing severe hemorrhage.
  • Avoid using hemoglobin to evaluate patients for iron deficiency in susceptible populations. Instead use ferritin.
  • Do not order a comprehensive stool ova and parasite (O&P) microscopic exam on patients presenting with diarrhea less than seven days’ duration who have no immunodeficiency or no history of living in or traveling to endemic areas where gastrointestinal parasitic infections are prevalent. If symptoms of infectious diarrhea persist for seven days or longer, start with molecular or antigen testing and next consider a full O&P microscopic exam if other testing is negative.

As part of the collaboration, ASCP has invited the ASCLS and ASM to each appoint a representative to serve a two-year term on ASCP’s Effective Test Utilization Committee. ASM has participated in the Choosing Wisely initiative for several years, and will collaborate with ASCP on the initiative in the future.

“We are honored that the ABIM Foundation reached out to ASCP to assist our colleagues at the ASCLS and ASM. It demonstrates the ABIM Foundation’s recognition of the work ASCP has done since 2012 to advance the Choosing Wisely initiative,” said ASCP Past President Lee H. Hilborne, MD, MPH, DLM(ASCP)CM, FASCP, Chair of the ASCP Effective Test Utilization Subcommittee.

ASCP is among the most active participants in the Choosing Wisely campaign, having developed 30 recommendations of tests that physicians should question before using. In 2016, the Society established a Choosing Wisely Champions program, which recognizes individual clinicians and laboratory teams who have made significant contributions to the campaign, inspired clinicians seeking to implement Choosing Wisely in their own practices, and demonstrated how clinicians are driving change in health care.

Under the partnership, the ASCLS and ASM representatives will provide subject matter expertise to help guide ASCP’s future priorities and recommendations, advocate for the Choosing Wisely initiative, and build awareness as to why the Choosing Wisely campaign provides pathologists and laboratory professionals an opportunity to make a positive impact on clinical outcomes and cost reduction.

“Since ASCP joined the Choosing Wisely campaign in 2012, many ASCP members have worked diligently to advance its ideals,” said ASCP President Gene Siegal, MD, PhD, FASCP. “As one of 80 medical societies in the Choosing Wisely campaign, ASCP is the only society representing pathology and laboratory medicine. Our goal is to identify the right test at the right time for the right cost to better serve our patients and improve the nation’s healthcare system.” 

For information about ASCP’s Choosing Wisely initiative, please contact Edna Garcia, MPH, Director, Scientific Engagement and Research at edna.garcia@ascp.org.

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