[Choosing wisely - perspectives: what are the key questions?]

[Choosing wisely - perspectives: what are the key questions?] Z Gastroenterol. 2020 Jul;58(7):652-658 Authors: Holstege A Abstract Gastroenterology offers a wide field for future "choosing wisely" recommendations (CWR). They should refer not only to an under- or overuse of diagnostic tools like laboratory or imaging tests but also to an evidence-based application of drug therapies und endoscopic interventions. Drugs like antibiotics or proton pump inhibitors are both often prescribed in the absence of clearly defined underlying diseases and not given when an indication is clear. Similar is true for the ordering of abdominal imaging methods. Computerized tomography of the abdomen too often is preferred over a qualified ultrasound study. Laboratory tests like amylase or lipase should not be ordered for asymptomatic patients since false positive values often end up with further useless and occasionally invasive examinations. Ordering both enzymes in acute pancreatitis will not provide any additional information. Similarly, CEA, ammonia or procalcitonin have either limited or no value in gastroenterology. Upper gastrointestinal endoscopy should not be performed in asymptomatic people without any risk factors. On the other hand, colonoscopy is still underused as a valuable screening tool for detection and secondary prevention of colorectal carcinomas in people over 50 years old.The dramatic rise in people suffering from obesity is paralle...
Source: Zeitschrift fur Gastroenterologie - Category: Gastroenterology Authors: Tags: Z Gastroenterol Source Type: research