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Choosing wisely: la lista del gruppo di studio Endocrinologia e Malattie del Metabolismo della Società Italiana di Patologia Clinica e Medicina di Laboratorio

Choosing wisely: the list of the group of study Endocrinology and Metabolic Diseases of Italian Society of Clinical Pathology and Laboratory Medicine

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La Rivista Italiana della Medicina di Laboratorio - Italian Journal of Laboratory Medicine

Riassunto

Premesse.

La necessità di promuovere l’appropriatezza delle procedure diagnostiche e terapeutiche è molto aumentata negli anni recenti a livello internazionale e nazionale. Le società scientifiche sono state coinvolte dal principio nella definizione di modalità e strumenti per supportare i soci nella “traduzione” nella pratica clinica di tale necessità, per esempio nella definizione di liste delle procedure diagnostiche e terapeutiche a maggior rischio di inappropriatezza. Questo ha consentito non solo di condividere delle priorità nell’ambito delle singole discipline, ma anche di confrontarsi con gli altri specialisti e, aspetto sempre più importante, con i pazienti e con i cittadini. I progetti che hanno avuto e continuano ad avere maggiore rilevanza a livello internazionale e nazionale sono, rispettivamente, Choosing Wisely e Slow Medicine.

La SIPMeL ha aderito a Slow Medicine e, in occasione del 1° Congresso Nazionale, ha presentato la lista delle 5 procedure a maggiore rischio di inappropriatezza nell’ambito della Medicina di Laboratorio.

Metodi.

Secondo i componenti del gruppo di studio Endocrinologia e Malattie del Metabolismo l’ambito di interesse del gruppo è di tale rilevanza diagnostica da suggerire l’utilità di proporre 5 procedure a rischio di inappropriatezza specifiche.

A questo riguardo è stato compiuto nel 2015 un sondaggio che ha coinvolto la maggioranza dei componenti del gruppo, i quali hanno indicato le 5 procedure che consideravano maggiormente a rischio. Le procedure indicate dovevano essere corredate da motivazioni, punteggio (da 1 a 10) e note bibliografiche.

Risultati.

Le 5 procedure che hanno ricevuto il punteggio più alto e che sono state selezionate si riferiscono a: (1) diagnostica ottimale della funzionalità tiroidea; (2) diagnostica ottimale della Sindrome di Cushing; (3) diagnostica ottimale del feomocromocitoma; (4) diagnostica ottimale di tireopatia autoimmune; (5) determinazione della 25 (OH) vitamina D.

Conclusioni.

Le 5 procedure sono state presentate in una sessione del 1° Congresso Nazionale della SIPMeL e diventeranno disponibili sul sito della Società. Si propone che anche gli altri gruppi di studio di SIPMeL preparino una analoga lista e ne diano diffusione all’interno della Società e della professione con modalità analoghe.

Summary

Background.

The need to promote the appropriateness of diagnostic and therapeutic procedures increased in the recent years in the world and in Italy. Scientific societies participated from the beginning in defining modes and tools to support the members in the “translation” of this need in the clinical practice, for example defining lists of the diagnostic and therapeutic procedures with the highest risk of inappropriateness. The most relevant projects at international and national levels were, respectively, Choosing wisely e Slow Medicine. SIPMeL is supporting Slow Medicine and presented at 2015 SIPMel National Congress the list of the 5 procedures with the highest risk of inappropriateness in Laboratory Medicine.

Methods.

In 2015 a survey has been carried out among the members of the Group of study Endocrinology-Metabolic diseases that were asked to vote (score 1–10) the five procedures with the highest risk of inappropriateness supporting their score with a short comment and essential references.

Results.

The final list was obtained from the sum of the scores and includes: (1) optimal assessment of thyroid function; (2) optimal diagnostics of Cushing syndrome; (3) optimal diagnostics of pheocromocytoma; (4) optimal diagnostics for autoimmune thyroid disease; (5) assessment of 25 (OH) vitamin D.

Conclusions.

The top five procedures have been presented at 2015 SIPMel National Congress and will be available in the Society website. We propose that also the other SIPMel groups of study prepare similar list and make them available within the Society and profession in a similar way.

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Authors and Affiliations

  1. UOC Patologia Clinica, AUSL della Romagna, Pievesestina di Cesena, FC, Italia

    Romolo M. Dorizzi

  2. Laboratorio Analisi, Sede di Borgo Trento, Azienda Ospedaliera Universitaria integrata di Verona, Verona, Italia

    Anna Ferrari, Beatrice Caruso & Claudio Cocco

  3. UOC di Patologia Clinica, Ospedale San Filippo Neri, Roma, Italia

    Marina Vitillo

  4. Studio Polispecialistico Potito, Campobasso, Italia

    Erennio Ciotoli

  5. Laboratorio di Patologia Clinica, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italia

    Federica D’Aurizio & Renato Tozzoli

  6. Palermo, Italia

    Elisa Esposito

  7. UOC Laboratorio Analisi, IRCCS Ospedale Pediatrico Bambino Gesù, Roma, Italia

    Germana Giannone & Ottavia Porzio

  8. UO Laboratorio Analisi Chimico Cliniche e Microbiologiche, USL 8, Arezzo, Italia

    Giulio Ozzola

  9. Dipartimento Medicina Sperimentale, Università di Tor Vergata, Roma, Italia

    Ottavia Porzio

  10. Laboratorio Patologia Clinica, Ospedale S. Chiara, Trento, Italia

    Emanuela Toffalori

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  1. Romolo M. Dorizzi
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  2. Anna Ferrari
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  3. Marina Vitillo
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Correspondence to Romolo M. Dorizzi.

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Per il Gruppo di Studio Endocrinologia e Malattie del Metabolismo della Società Italiana di Patologia Clinica e Medicina di Laboratorio.

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Dorizzi, R.M., Ferrari, A., Vitillo, M. et al. Choosing wisely: la lista del gruppo di studio Endocrinologia e Malattie del Metabolismo della Società Italiana di Patologia Clinica e Medicina di Laboratorio. Riv Ital Med Lab 12, 81–88 (2016). https://doi.org/10.1007/s13631-016-0115-9

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