Choosing Wisely Campaign Adds More Imaging Tests to List

Under the umbrella of the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely^® program, 17 medical specialty societies have identified additional commonly ordered tests, procedures or medication therapies they say are not always necessary—with some even causing undue harm. For example, the American Academy of Pediatrics advised the following:

Don’t automatically use CT scans to evaluate children’s minor head injuries. Approximately 50 percent of children who visit hospital emergency departments with head injuries are given a CT scan. CT scanning is associated with radiation exposure that may escalate future cancer risk. The recommendation calls for clinical observation prior to making a decision about needing a CT.

The American Society of Echocardiography advised physicians to:

Avoid doing stress tests using echocardiographic images to assess cardiovascular risk in persons who have no symptoms and a low risk of having coronary disease. The recommendation states that there is very little information on the benefit of using stress echocardiography in asymptomatic individuals for the purposes of cardiovascular risk assessment, as a stand-alone test or in addition to conventional risk factors.

In all, the 17 medical specialty societies, including the Society of Nuclear Medicine and Molecular Imaging, identified 90 tests that merited scrutiny. To date, more than 130 tests and procedures to question have been released as part of the ABIM Foundation’s Choosing Wisely^® campaign, which aims to spark conversations between patients and physicians about what care is really necessary. “In less than a year, more than 70 million consumers have received practical advice about medical tests and treatments that are often overused or inappropriate,” said James A. Guest, J.D., president and CEO of Consumer Reports via press release. “And we applaud the courage of the specialty societies for addressing overuse and encouraging informed patient-doctor dialogue.”   Each specialty society participating in Choosing Wisely identified five specific tests or procedures that are commonly done in their profession, but whose use should be questioned. In April 2012, nine medical specialty societies each released Choosing Wisely lists. Complete lists from the specialty societies, available at www.ChoosingWisely.org, include additional detail about the recommendations and supporting evidence.