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La Rivista Italiana della Medicina di Laboratorio 2022 Marzo;18(1):7-10

DOI: 10.23736/S1825-859X.22.00133-5


lingua: Italiano

Lista Choosing Wisely della Società Italiana di Patologia Clinica e Medicina di Laboratorio (2022): una proposta di aggiornamento

Romolo M. DORIZZI 1 , Piero CAPPELLETTI 1, Mariacaterina MACONI 2

1 SIPMeL, Castelfranco Veneto, Treviso, Italia; 2 Azienda Sanitaria Locale Alessandria, Alessandria, Italia

The Evidence Based Laboratory Medicine Group of study of the Italian Society of Clinical Pathology and Laboratory Medicine (EBLM GdS) adopted the approach of the American Society of Clinical Pathology and, rather than replacing the 2017 recommendations, is proposing to add five recommendations to the current SIPMeL Choosing wisely (CW) list involving the Society members. The EBLM GdS reviewed the 35 ASCP-CW, CW-Canada and CW-Australia recommendations and identified the five that possess the greatest relevance for Italian laboratories. This observatory identified five recommendations: 1) do not request amylase in addition to lipase when acute pancreatitis is suspected; 2) do not request erythrocyte sedimentation rate (ESR) measurement to screen asymptomatic patients or as a general test to detect inflammatory states in patients with undiagnosed conditions; 3) do not request serum ammonium for diagnosis or management of hepatic encephalopathy (EE); 4) do not request serum protein electrophoresis in asymptomatic patients in the absence of hypercalcemia, renal failure, anemia, or bone lytic lesions not otherwise explainable; and 5) do not request uric acid as part of routine assessment of cardiovascular risk, obesity, or diabetes. This preliminary draft presents a more extensive description and references than the previous SIPMeL-CW list in order to provide members with more elements to evaluate them and, if approved, it will be abridged. The sharing of the recommendations by SIPMeL members will be done through: 1) publication of the article in the official journal of SIPMeL; 2) sending the article to all members; and 3) presentation at the National Congress 2022. The five recommendations, if approved, will be forwarded to the National Council and to Choosing Wisely Italy for evaluation.

KEY WORDS: Lipase; Ammonia; Uric acid; Electrophoresis; Erytrocyte sedimentation rate

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