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:
- 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.
- 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
- 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
- Do not perform baseline or routine surveillance CT scans or bone marrow biopsy in patients with asymptomatic early stage chronic lymphocytic leukaemia (CLL).
- 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.