Abstract
BackgroundOne of the main problem health care systems are facis is the mis-use and over-use of medical resources (including useless exams, surgical interventions, medical treatments, screening procedures…) which may lead to high health care related costs without increased patients’ benefit and possible harm to the patients themselves. The “Choosing wisely” campaign, in Italy denominated “Doing more does not mean doing better”, tries to educate doctors and citizens at a correct use of medical resources.Methodsthe Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC) adhered to the “Doing more does not mean doing better” campaing and made a list of the 5 allergological procedures with the highest evidence of inappropriateness.Resultsthe 5 recommendations were: “Do not perform allergy tests for drugs (including anhestetics) and/or foods when there are neither clinical history nor symptoms suggestive of hypersensitivity reactions”; “Do not perform the so-called “food intolerance tests” (apart from those which are validated for suspect celiac disease or lactose enzymatic intolerance)”; “Do not perform serological allergy tests (i.e.: total IgE, specific IgE, ISAC) as first-line tests or as “screening” assays”; “Do not treat patients sensitized to allergens or aptens if there is not a clear correlation between exposure to that specific allergen/apten and symptoms suggestive of allergic reaction”; “Do not diagnose asthma without having performed lung function tests”.ConclusionsAn important role scientific societies should play is to advise on correct diagnostic and therapeutical pathways. For this reason SIAAIC decided to adhere to the Slow Medicine Italy campaign “Doing more does not mean doing better” with the aim of warning the scientific community and the citizens/patients about some allergological procedures, which, when performed in the wrong clinical setting, may be not only useless, but unnecessarily expensive and even harmful for patients’ health.
Highlights
IntroductionOne of the main problem health care systems are facis is the mis-use and over-use of medical resources (including useless exams, surgical interventions, medical treatments, screening procedures...) which may lead to high health care related costs without increased patients’ benefit and possible harm to the patients themselves
One of the main problem health care systems are facis is the mis-use and over-use of medical resources which may lead to high health care related costs without increased patients’ benefit and possible harm to the patients themselves
In the last few years, we assisted to a worldwide dramatic increase in interest in the “Slow Medicine” concept, and this was endorsed by the former British Medical Journal (BMJ) editor in chief, professor Richard Smith, which wrote: “slow medicine—like slow food and slow lovemaking—is the best kind of medicine for the 21st century” [3]
Summary
One of the main problem health care systems are facis is the mis-use and over-use of medical resources (including useless exams, surgical interventions, medical treatments, screening procedures...) which may lead to high health care related costs without increased patients’ benefit and possible harm to the patients themselves. One of the main problem the “Slow Medicine” approach is trying to face to promote possible solutions, is the mis-use and over-use of medical resources (including useless exams, surgical interventions, medical treatments, screening procedures...) which is well known to lead to both high health care related costs without increased patients’ benefit [4] and possible harm to the patients themselves [5, 6] Into this context, the “Choosing wisely” campaign started in the USA in 2012 [7, 8] and spread in several other countries, including Italy with the name “Doing more does not mean doing better” (“Fare di più non significa fare meglio” in Italian) [9,10,11], has the main goal of identifying the most probable inappropriate medical procedures for each specialty, protecting patients’ interests through a partnership between health professionals and patients and users [12]. In this article we will described and discuss the methodology used and the obtained results to make the list of five allergological procedures with the highest probability of inappropriateness
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