The American Society for Clinical Pathology Expands List of Commonly Used Tests Physicians and Patients Should Question, in Collaboration with ASCLS and ASM

Laboratory Community’s Contributions to ABIM Foundation’s Choosing Wisely Campaign Help Reduce Overall Waste in Health Care 

ASCP, in collaboration with the American Society for Clinical Laboratory Science (ASCLS) and the American Society for Microbiology (ASM), has released two new lists of recommendations for laboratory tests that are commonly ordered but not always appropriate in pathology and laboratory medicine. The recommendations are part of the Choosing Wisely campaign, an initiative of the ABIM Foundation. The lists of targeted, evidence-based recommendations are designed to support conversations between patients and physicians about what care is really necessary. The recommendations ensure patients receive the right testing at the right time. This brings the lists of recommendations to seven for ASCP, with two additional lists developed with ASM and ASCLS to help reduce waste in health care by lowering the number of unnecessary tests and treatments.

The new Choosing Wisely recommendations, developed by ASCP in collaboration with ASCLS, include:

1. Don't repeat HbA1c testing within 3 months of a previous result.

2. Don't perform an extensive work-up in otherwise healthy neutropenic patients of African or Middle Eastern ancestry prior to Duffy-null phenotype testing.

3. Don’t order ANA and ENA unless the patient is suspected to have a connective tissue disease

4. Do not measure the INR in patients who are taking an anti-Xa inhibitor. 

5. Don’t employ a specific direct oral anticoagulant [DOAC] reversal agent without identifying the DOAC and estimating its plasma concentration.  [Developed by American Society for Clinical Laboratory Science Choosing Wisely Committee]

The new Choosing Wisely recommendations, developed by ASCP with ASCLS and ASM, include:

1. Do not routinely send urine for Chlamydia trachomatis and Neisseria gonorrhoeae (CT/NG) testing from females if vaginal swab collection is possible. [Developed by American Society of Microbiology’s Clinical and Public Health Microbiology Committee]

2. Do not perform heterophile antibody (monospot) testing to diagnose acute EBV infection in children less than 5 years of age. [Developed by American Society of Microbiology’s Clinical and Public Health Microbiology Committee]

3. Do not test for influenza unless the patient is symptomatic and the result will influence clinical management and decision making. [Developed by American Society for Clinical Laboratory Science Choosing Wisely Committee]

4. Do not prescribe immune suppressive agents for suspected autoimmune hepatitis without first excluding hepatotropic virus infections (e.g., viral hepatitis A, B, and C). Viral hepatitis may mimic AIH, both serologically and histologically, features that may resolve with direct-acting antiviral treatment. [Developed by American Society for Clinical Laboratory Science Choosing Wisely Committee]

5. Don’t order tissue transglutaminase IgG antibody or Deamidated Gliadin Peptide antibodies in the initial screening for Celiac Disease.

“ASCP is honored to be part of this important quality initiative,” says Lee H. Hilborne, MD, MPH, FASCP, DLM(ASCP)^CM, Chair of ASCP’s Effective Test Utilization Steering Committee and a Past President of ASCP. “As ASCP continues to expand our recommendations in partnership with ASM and ASCLS, we expect to see increasing higher quality, appropriate care with lower costs, and more effective use of our medical laboratory resources and personnel. 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.”

To learn more about ASCP’s involvement in Choosing Wisely and access the new list of recommendations, here.

About ASCP
Founded in 1922 in Chicago, ASCP is a medical professional society with more than 100,000 member board-certified anatomic and clinical pathologists, pathology residents and fellows, laboratory professionals, and students. ASCP provides excellence in education, certification, and advocacy on behalf of patients, pathologists, and laboratory professionals. To learn more, visit www.ascp.org. Follow us on Twitter at www.twitter.com/ascp_chicago and connect with us on Facebook at www.facebook.com/ASCP.Chicago. 

About ASCLS
The American Society for Clinical Laboratory Science (ASCLS) and its 9,000 clinical laboratory professional, student, and educator members in more than 50 state and regional constituent societies work to advance the expertise of clinical laboratory professionals who, as integral members of interprofessional healthcare teams, deliver quality, consumer-focused, outcomes-oriented clinical laboratory services through all phases of the testing process to prevent, diagnose, monitor and treat disease. The Society promotes high standards of practice by holding the profession accountable to a Code of Ethics, through dissemination of knowledge at educational programs and through publications; maintains a supportive community to advocate on behalf of current and future laboratory professionals; and provides laboratory professionals a voice to legislators and regulators through collective, grassroots efforts. To learn more, visit https://ascls.org/.

About ASM 
The American Society for Microbiology (ASM) is the largest single life science society, composed of 30,000 scientists and health professionals. ASM's mission is to promote and advance the microbial sciences. ASM advances the microbial sciences through conferences, publications, certifications and educational opportunities. It enhances laboratory capacity around the globe through training and resources. It provides a network for scientists in academia, industry and clinical settings. Additionally, ASM promotes a deeper understanding of the microbial sciences to diverse audiences. To learn more, visit https://asm.org/.

About the ABIM Foundation
The mission of the ABIM Foundation is to advance medical professionalism to improve the health care system. We achieve this by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policy makers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit www.abimfoundation.org, connect with us on Facebook or follow us on Twitter. 

About Choosing Wisely®
First announced in December 2011, Choosing Wisely® is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources. Participating specialty societies are working with the ABIM Foundation to share the lists widely with their members and convene discussions about the physician’s role in helping patients make wise choices. Learn more at www.ChoosingWisely.org.  
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