Choosing Wisely: Do I Really Need that Test, Treatment or Procedure?

Christopher Smith Archive

Patients and members of the Canadian Rheumatology Association (CRA) have collaborated to make recommendations for curbing diagnostic tests and treatments that may be overused or inappropriately ordered. The recommendations are made under Choosing Wisely Canada, a national campaign organized in partnership with the Canadian Medical Association to reduce unnecessary medical tests, treatments and procedures.

The recommendations are as follows:

1. Don’t order an anti-nuclear antibody test as a screening test in patients without specific signs or symptoms of systemic lupus erythematosus or another connective tissue disease.
2. Don’t order an HLA-B27 genetic test unless spondyloarthritis is suspected based on specific signs or symptoms. (Spondyloarthritis is a group of inflammatory arthritis diseases.)
3. Don’t repeat dual energy X-ray absorptiometry (DEXA) scans more often than every 2 years.
4. Don’t prescribe bisphosphonates for patients at low risk of fracture.
5. Don’t perform whole body bone scans (e.g., scintigraphy) for diagnostic screening for peripheral and axial arthritis in adults.

Unnecessary tests do not add value to care and could be hazardous. More medicine doesn’t always mean better medicine. Find out more about the CRA’s Choosing Wisely recommendations. Find out more about the Choosing Wisely Canada campaign.