Top 5 list of interventions not-to-do


15 Feb 2016

The Haematology Society of Australia and New Zealand has published its top 5 list of ‘do-not-do’ interventions and practices.

The list was published as part of the EVOLVE program,  a physician-led initiative that encourages each medical specialty to think about the clinical circumstances in which some of their practices – whether medical tests, procedures or interventions – should have their indications or value questioned and discussed by physicians.

HSANZ’s top 5 list of low value interventions and practices:

  1. Do not conduct thrombophilia testing in adult patients under the age of 50 years ​unless the first episode of venous thromboembolism (VTE): occurs in the absence of major transient risk factors (surgery, trauma, immobility); or, occurs in the absence of oestrogen-provocation; or, occurs at an unusual site.
  1. Limit surveillance computed tomography (CT) scans in asymptomatic patients with confirmed complete remission following curative intent treatment for aggressive lymphoma – except for patients on a clinical trial
  1. Do not extend anticoagulation beyond 3 months for a patient with a nonextensive, index venous thromboembolic event (VTE), which occurred in the setting of a major, transient risk factor
  1. Do not perform baseline or routine surveillance CT scans or bone marrow biopsy in patients with asymptomatic early stage chronic lymphocytic leukaemia (CLL).
  2. Do not treat patients with immune thrombocytopenic purpura (ITP) in the absence of bleeding or a platelet count <30,000/L without risk factors for bleeding.



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