Five common errors to avoid in clinical practice: the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) Choosing Wisely Campaign

Elisa Stasi, Andrea Michielan, Gaetano Cristian Morreale, Alessandro Tozzi, Ludovica Venezia, Francesco Bortoluzzi, Omero Triossi, Marco Soncini, Gioacchino Leandro, Giuseppe Milazzo, Andrea Anderloni

Research output: Contribution to journalArticle

Abstract

Modern medicine provides almost infinite diagnostic and therapeutic possibilities if compared to the past. As a result, patients undergo a multiplication of tests and therapies, which in turn may trigger further tests, often based on physicians' attitudes or beliefs, which are not always evidence-based. The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) adhered to the Choosing Wisely Campaign to promote an informed, evidence-based approach to gastroenterological problems. The aim of this article is to report the five recommendations of the AIGO Choosing Wisely Campaign, and the process used to develop them. The AIGO members' suggestions regarding inappropriate practices/interventions were collected. One hundred and twenty-one items were identified. Among these, five items were selected and five recommendations were developed. The five recommendations developed were: (1) Do not request a fecal occult blood test outside the colorectal cancer screening programme; (2) Do not repeat surveillance colonoscopy for polyps, after a quality colonoscopy, before the interval suggested by the gastroenterologist on the colonoscopy report, or based on the polyp histology report; (3) Do not repeat esophagogastroduodenoscopy in patients with reflux symptoms, with or without hiatal hernia, in the absence of different symptoms or alarm symptoms; (4) Do not repeat abdominal ultrasound in asymptomatic patients with small hepatic haemangiomas (diameter < 3 cm) once the diagnosis has been established conclusively; (5) Do not routinely prescribe proton pump inhibitors within the context of steroid use or long-term in patients with functional dyspepsia. AIGO adhered to the Choosing Wisely Campaign and developed five recommendations. Further studies are needed to assess the impact of these recommendations in clinical practice with regards to clinical outcome and cost-effectiveness.

Original languageEnglish
Pages (from-to)301-308
Number of pages8
JournalInternal and Emergency Medicine
Volume14
Issue number2
DOIs
Publication statusPublished - Mar 2019

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Colonoscopy
Polyps
Digestive System Endoscopy
Occult Blood
Modern 1601-history
Hiatal Hernia
Proton Pump Inhibitors
Dyspepsia
Hematologic Tests
Hemangioma
Early Detection of Cancer
Cost-Benefit Analysis
Colorectal Neoplasms
Histology
Steroids
Physicians
Gastroenterologists
Liver
Therapeutics

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Five common errors to avoid in clinical practice : the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) Choosing Wisely Campaign. / Stasi, Elisa; Michielan, Andrea; Morreale, Gaetano Cristian; Tozzi, Alessandro; Venezia, Ludovica; Bortoluzzi, Francesco; Triossi, Omero; Soncini, Marco; Leandro, Gioacchino; Milazzo, Giuseppe; Anderloni, Andrea.

In: Internal and Emergency Medicine, Vol. 14, No. 2, 03.2019, p. 301-308.

Research output: Contribution to journalArticle

Stasi, Elisa ; Michielan, Andrea ; Morreale, Gaetano Cristian ; Tozzi, Alessandro ; Venezia, Ludovica ; Bortoluzzi, Francesco ; Triossi, Omero ; Soncini, Marco ; Leandro, Gioacchino ; Milazzo, Giuseppe ; Anderloni, Andrea. / Five common errors to avoid in clinical practice : the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) Choosing Wisely Campaign. In: Internal and Emergency Medicine. 2019 ; Vol. 14, No. 2. pp. 301-308.
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