A Learning Process
The Endocrine Society’s leadership wanted to participate in the Choosing Wisely program in order to help endocrinologists engage patients in important discussions about their health and the benefits of various treatment options, says Robert Lash, M.D., University of Michigan Health System, who served as chairman of the Joint Task Force of the Endocrine Society and American Association of Clinical Endocrinologists members who developed the Choosing Wisely list.
“These are observations of experts, not guidelines or standards of care,” says Lash, referringto the list. “Given that each patient and situation is unique, there are many exceptions, and the recommendations are likely to evolve with advances in research. Endocrinologists are free to use this resource as they see fit.
“Thanks to ongoing research, we are always learning more about the best approaches for treating people with hormone and metabolic conditions. Although the Society does not have any current plans to create a new list, as clinical practice evolves, the Society would consider developing a new Choosing Wisely list in the future.”
Endocrine Society and American Association of Clinical Endocrinologists:
Five Things Physicians and Patients Should Question
- Avoid routine multiple daily self-glucose monitoring in adults with stable type 2 diabetes on agents that do not cause hypoglycemia.
- Don’t routinely measure 1,25-dihydroxyvitamin D unless the patient has hypercalcemia or decreased kidney function.
- Don’t routinely order a thyroid ultrasound in patients with abnormal thyroid function tests if there is no palpable abnormality of the thyroid gland.
- Don’t order a total or free T3 level when assessing levothyroxine (T4) dose in hypothyroid patients.
- Don’t prescribe testosterone therapy unless there is biochemical evidence of testosterone deficiency.
Source: Choosing Wisely, an initiative of the ABIM Foundation,
http://www.choosingwisely.org/wp-content/uploads/2013/02/Choosing-Wisely-Master-List.pdf