Don’t request amylase in addition to lipase if acute pancreatitis is suspected.
The diagnosis of acute pancreatitis is based on persistent and severe abdominal pain, high blood lipase or amylase value, and characteristic imaging. Lipase is more sensitive and specific than amylase and remains high longer.
Don’t request erythrocyte sedimentation rate to screen asymptomatic patients or as a general test to look for inflammatory states in patients with undiagnosed conditions.
C-reactive protein (CRP) is more sensitive, specific and rapid in the acute phase of inflammation. CRP should be preferred to detect both the onset and resolution of a systemic inflammatory state.
Don’t request blood ammonium measurement for diagnosis or management of hepatic encephalopathy (HE) in patients with chronic hepatopathy.
High blood ammonium alone adds no information in the diagnosis, staging, and prognosis of hepatic encephalopathy (HE) in patients with chronic hepatopathy, and ammonium concentration rarely correlates with symptoms severity and outcomes.
Don’t measure procalcitonin outside of evidence-based protocols defined by professional Societies or at the health organization/regional/national level.
Procalcitonin (PCT) has been proposed to discriminate infections and in, particular, bacterial sepsis from viral and other causes and to reduce antibiotic prescribing. The heterogeneity of measurement methods, adopted cut-offs and recommended protocols have greatly...The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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