Top 10 Pathology Tests to Avoid

The Royal College of Pathologists of Australasia (RCPA) this month has unveiled new guidelines to reduce Inappropriate Pathology Requesting in Australasia.

The Top 10 recommendations are :

  • Do not perform surveillance urine cultures or treat asymptomatic bacteriuria in older patients unless there are urinary tract signs and symptoms.
  • Do not perform population-based screening for vitamin D deficiency.
  • Do not perform PSA testing for prostate cancer screening in men with no symptoms and whose life expectancy is less than 10 years.
  • Do not perform routine pre-operative screening tests for low-risk surgery.
  • Do not perform IgG4 allergy tests, total IgE (or indiscriminate batteries of IgE tests) in the investigation of allergy.
  • Do not perform heavy metal tests for non-specific symptoms in the absence of exposure.
  • Do not test for Lyme disease for non-specific symptoms in the absence of exposure (travel to endemic areas).
  • Do not perform serum tumour marker tests except for the monitoring of a cancer known to produce these markers.
  • Do not routinely test and treat hyperlipidaemia in those with a limited life expectancy.
  • Do perform high sensitivity D-dimer assay in outpatients rather than imaging to exclude venous thrombo-embolism in patients with a low clinical probability.

The guidelines are available to download here

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