Opinion Based List:
5 Things Physicians and Patients Should Question - American Academy of Allergy, Asthma & Immunology
- Don’t perform unproven diagnostic tests, such as immunoglobulin G (IgG) testing or an indiscriminate battery of immunoglobulin E (IgE) tests, in the evaluation of allergy.
- Don’t order sinus computed tomography (CT) or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis.
- Don’t routinely do diagnostic testing in patients with chronic urticaria.
- Don’t recommend replacement immunoglobulin therapy for recurrent infections unless impaired antibody responses to vaccines are demonstrated.
- Don’t diagnose or manage asthma without spirometry.
Notes: The American Board of Internal Medicine (ABIM) is encouraging the healthcare industry to change the way testing and procedures are handled in order to reduce waste and minimize the potential risk to patients. A recent JAMA study, “The ‘Top 5’ Lists in Primary Care: Meeting the Responsibility of Professionalism”, estimated that just 12 unnecessary treatments and screenings accounted for $6.8 billion of 2009’s medical cost. Choosing Wisely, an initiative by the ABIM, aims to help physicians use healthcare resources more wisely. Originally a pilot by the National Physicians Alliance, nine medical specialty organizations as well as Consumer Reports have identified five tests or procedures commonly used in their fields whose necessity should be questioned.
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