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"Choosing Wisely" Calls Out Inappropriate Testing in Patients with Diarrhea or Hepatitis C

By the Editors

The American Society for Clinical Pathology has released five additional practices to question or avoid as part of the Choosing Wisely campaign. Here they are:

• Hospitalized patients who develop diarrhea after 3 days in the hospital should not be routinely tested for community gastrointestinal pathogens.
• Patients who've had a positive test for hepatitis C virus antibodies should not undergo repeat antibody testing. Rather, they should have their viral load measured to assess whether their infection is active or resolved.
• Those taking direct factor Xa inhibitors (e.g., apixaban) or direct thrombin inhibitors (e.g., dabigatran) should not receive a hypercoagulable workup.
• When evaluating a patient for pheochromocytoma or paraganglioma, do not use plasma catecholamines. Use plasma free metanephrines or urinary fractionated metanephrines instead.
• Broad respiratory pathogen panels shouldn't be regularly used unless the findings are expected to influence patient management.

Choosing Wisely list (see items 26-30) (Free)

Background: Physician's First Watch coverage of recent Choosing Wisely list from the American Academy of Pediatrics (Free)

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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