Choosing Wisely Adds Some Post-Op DVT Ultrasounds to List of Questionable Procedures

Avoid performing routine post-operative deep vein thrombosis (DVT) ultrasonography screening in patients who undergo elective hip or knee arthroplasty, says the American Academy of Orthopaedic Surgeons (AAOS) in its contribution to the Choosing Wisely list of frequently ordered but often unnecessary medical tests and procedures. The Choosing Wisely campaign is an initiative of the American Board of Internal Medicine (ABIM) Foundation. Through partnerships with national organizations representing medical specialists (including the ACR), as well as Consumer Reports and a number of consumer-focused organizations, Choosing Wisely aims help curb the overutilization of medical care in the United States by prompting physicians and patients discuss when and when not to treat or test. The AAOS put post-operative deep vein thrombosis ultrasonography screening on the Choosing Wisely list of medical tests and procedures to question because studies show that ultrasound is ineffective at diagnosing deep vein thrombosis (DVT) in post-operative patients without other symptoms of DVT. Routine post-operative screening for DVT after hip or knee arthroplasty does not change outcomes or clinical management, the AAOS reasoned. "Identifying tests, procedures or treatments that show little to no value not only helps our patients by preventing unnecessary care, but will end up saving health care dollars," stated Joshua J. Jacobs, MD, AAOS president, in the press release. The American Society for Radiation Oncology is due to add its recommendations to the list on September 23. The ACR is not among the 30 medical specialty organizations contributing to the growing Choosing Wisely list in 2013 or 2014, but it was one of the first groups to join the initiative, and it contributed to the list in 2012.View the full list of participating societies.