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Do not order a frozen section on a pathology specimen if the result will not affect immediate (i.e., intraoperative or perioperative) patient management.
Choosing Wisely®
American Society for Clinical Pathology
Although the result of an intraoperative frozen section evaluation is often helpful to determine the treatment path of a patient during a surgical procedure, the frozen section analysis may be limited in regards to sampling and technical issues that can hinder interpretation and/or compromise the integrity of the specimen for the final diagnosis. If there is no therapeutic decision to be made for the patient on the day of the surgical procedure based on the results of the frozen section, it is ...
ver más ... 2017Do not use sputum cytology to evaluate patients with peripheral lung lesions.
Choosing Wisely®
American Society for Clinical Pathology
Sputum cytology is not effective for evaluating peripheral lesions. For peripheral lesion evaluation, consider alternative diagnostic approaches (e.g., image guided needle aspiration).
ver más ... 2017Do not order red blood cell folate levels at all. In adults, consider folate supplementation instead of serum folate testing in patients with macrocytic anemia.
Choosing Wisely®
American Society for Clinical Pathology
Since 1998, when the U.S. and Canada mandated that foods with processed grains be fortified with folic acid, there has been a significant decline in the incidence of folate deficiency. For the rare patient suspected of having a folate deficiency, simply treating with folic acid is a more cost-effective approach than blood testing. While red blood cell folate levels have been used in the past as a surrogate for tissue folate levels or a marker for folate status over the lifetime of red blood ...
ver más ... 2017Do not test for Protein C, Protein S, or Antithrombin (ATIII) levels during an active clotting event to diagnose a hereditary deficiency because these tests are not analytically accurate during an ...
Choosing Wisely®
American Society for Clinical Pathology
These assays may be useful to test for an acquired deficiency (i.e., disseminated intravascular coagulation) in consumptive coagulopathies. These tests are not analytically accurate during an active clotting event. Moreover they are not clinically actionable at the time of an acute clot, because the same therapeutic intervention (anticoagulation) is performed regardless of the results. Deferral to the outpatient/non-acute setting allows for the testing to be done at a time when the results ...
ver más ... 2017Do not repeat hemoglobin electrophoresis (or equivalent) in patients who have a prior result and who do not require therapeutic intervention or monitoring of hemoglobin variant levels.
Choosing Wisely®
American Society for Clinical Pathology
Pre-conception and antenatal hemoglobin electrophoresis screening is recommended, especially in high prevalence areas for sickle cell disease or thalassemia, and has become routine practice in order to detect abnormalities of hemoglobins S, C, D-Punjab, E, O-Arab, Lepore, beta-thalassemia trait, delta/beta thalassemia trait, alpha thalassemia trait (2 chain deletion), and hereditary persistence of fetal hemoglobin (HPFH). Partner testing should be offered when there is a risk of a significant ...
ver más ... 2017