Endocrinologists Release List of Commonly Used Tests and Treatments to Question

List contains common tests to avoid as well as tests patients with diabetes really should be conducting.

The Endocrine Society and the American Association of Clinical Endocrinologists (AACE) released a list of specific tests or procedures that are commonly ordered but not always necessary in endocrinology as part of Choosing Wisely, an initiative of the ABIM Foundation.

In their list, The Endocrine Society and AACE identified the following five recommendations:

  • Avoid routine multiple daily self-glucose monitoring in adults with stable type 2 diabetes on agents that do not cause hypoglycemia.
  • Do not routinely measure 1.25 dihydroxyvitamin D unless the patient has hypercalcemia or decreased kidney function.
  • woman getting ultrasound of a thyroid from doctor Do not routinely order a thyroid ultrasound in patients with abnormal thyroid function tests if there is no palpable abnormality of the thyroid gland.
  • Do not order a total or free T3 level when assessing levothyroxine (T4) dose in hypothyroid patients.
  • Do not prescribe testosterone therapy unless there is biochemical evidence of testosterone deficiency.

“These recommendations give endocrinologists a platform to engage patients in important discussions about their health and the benefits of various treatment options,” said Endocrine Society President Teresa K. Woodruff, PhD. “We are pleased to be empowering patients and physicians to be true partners in determining the wisest course of care for each individual.”

“AACE/ACE is pleased to participate in these discussions, and reminds readers that these recommendations are not meant as guidelines or standards of care, but rather the observations of experts,” said American College of Endocrinology (ACE) President Daniel Einhorn, MD. “Each patient and encounter is unique, and there are many exceptions to each of the recommendations. Furthermore, the recommendations are likely to evolve over time as more is learned.”

TheChoosing Wisely list was developed after months of careful consideration and review. Members of The Endocrine Society along with representatives of AACE formed a joint task force to identify tests or procedures that should only be used in specific circumstances. With input from members of the Society’s Council, Clinical Affairs Core Committee and AACE’s Board of Directors and other leaders, the task force selected the final list based on the amount of evidence supporting each item, the value of the recommendation to practitioners, and the potential for cost savings.

“The Endocrine Society and AACE have shown tremendous leadership by releasing this list of tests and procedures they say are commonly done in endocrinology, but aren’t always necessary,” said Richard J. Baron, MD, president and CEO of the ABIM Foundation. “The content of this list and all of the others developed through this effort are helping physicians and patients across the country engage in conversations about what care they need, and what we can do to reduce waste and overuse in our health care system.”

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. To date, more than 80 national and state medical specialty societies, regional health collaboratives and consumer partners have joined the conversations about appropriate care. Including new lists scheduled for release through March 2014, the campaign will have covered more than 250 tests and procedures that the specialty society partners say are overused and inappropriate, and that physicians and patients should discuss.

To learn more about Choosing Wisely and to view the complete lists and additional detail about the recommendations and evidence supporting them, visit www.ChoosingWisely.org.

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