As Part of Choosing Wisely® Campaign, Endocrinologists Release List of Commonly Used Tests and Treatments to Question

List encourages physician and patient conversations by highlighting potentially unnecessary—sometimes harmful—care in endocrinology

Wednesday, October 16, 2013 11:57 am EDT

Dateline:

CHEVY CHASE, Md. and JACKSONVILLE, Fla.
"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."

The Endocrine Society and the American Association of Clinical Endocrinologists (AACE) today 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. The list identifies five targeted, evidence-based recommendations that can support conversations between patients and physicians about what care is really necessary.

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.
  • 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, FACP, FACE. “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.”

The endocrinology Choosing Wisely list was developed after months of careful consideration and review, using the most current evidence about management and treatment options.

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.

About The Endocrine Society
Founded in 1916, The Endocrine Society is the world’s oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology.  Today, The Endocrine Society’s membership consists of over 16,000 scientists, physicians, educators, nurses and students in more than 100 countries. Society members represent all basic, applied and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at https://twitter.com/#!/EndoMedia.

About the American Association of Clinical Endocrinologists (AACE)
The American Association of Clinical Endocrinologists (AACE) represents more than 6,500 endocrinologists in the United States and abroad. AACE is the largest association of clinical endocrinologists in the world. The majority of AACE members are certified in endocrinology, diabetes and metabolism and concentrate on the treatment of patients with endocrine and metabolic disorders including diabetes, thyroid disorders, osteoporosis, growth hormone deficiency, cholesterol disorders, hypertension and obesity. Visit our site at www.aace.com.

About the American College of Endocrinology (ACE)
The American College of Endocrinology (ACE) is the educational and scientific arm of the American Association of Clinical Endocrinologists (AACE). ACE is the leader in advancing the care and prevention of endocrine and metabolic disorders by: providing professional education and reliable public health information; recognizing excellence in education, research and service; promoting clinical research and defining the future of Clinical Endocrinology. For more information, please visit www.aace.com/college.

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