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Hematology Society Releases List of Questionable Tests and Treatments

Experts make five evidence-based recommendations (December 4)

As part of the Choosing Wisely initiative, the American Society of Hematology (ASH) has issued a list of common hematology tests, treatments, and procedures that are not always necessary.

The list, published online in Blood, makes five evidence-based recommendations in an effort to prompt conversations between patients and physicians about the necessity and potential harm of certain practices.

ASH identifies the following five tests, treatments, and procedures that hematologists and their patients should question:

  • Limit surveillance computed tomography (CT) scans in asymptomatic patients following curative-intent treatment for aggressive lymphoma.
  • Don’t use inferior vena cava (IVC) filters routinely in patients with acute venous thromboembolism (VTE).
  • Don’t transfuse more than the minimum number of red blood cell (RBC) units necessary to relieve symptoms of anemia or to return a patient to a safe hemoglobin range (7 to 8 g/dL in stable noncardiac inpatients).
  • Don’t test for thrombophilia in adult patients with VTE that occurs in the setting of major transient risk factors, such as surgery, trauma, or prolonged immobility.
  • Don’t administer plasma or prothrombin complex concentrates for non-emergent reversal of vitamin K antagonists (i.e., outside of the setting of major bleeding, intracranial hemorrhage or anticipated emergent surgery).

Source: ASH; December 4, 2013.

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