SIPMeL

SIPMeL
Italian Society for Clinical Pathology and Laboratory Medicine

5 recommendations - second list from EVIDENCE BASED LABORATORY Medicine Study Group


released: 1 September 2023
last updated: 1 September 2023

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How this list was created

An article by SIPMeL’s EBLM Working Group (WG) accessible online to all the association members (Riv Ital Med Lab 2022;7:7-10) proposed five new “procedures at greatest risk of inappropriateness” that were presented in a joint session with Choosing Wisely Italy at the 7th SIPMeL National Congress. The final list was approved after discussion at the session. In July 2023, an article by the EBLM WG containing a critical evaluation of the available relevant literature and the rationale supporting the inclusion of the individual recommendations was sent, after approval by the National President of SIPMeL, to La Rivista italiana della Medicina di Laboratorio.

5 recommendations from AUTOIMMUNOLOGY Study Group

Anti-TPO and anti-Tg antibodies should not be sought in the case of autoimmune thyrotoxicosis / hyperthyroidism; search instead for anti-TSHR antibodies (TRAb). The research of anti-TPO is useful only in case of negativity of TRAb (possible diagnosis of non-Graves thyrotoxicosis).
Do not request anti-TPO (anti-thyroid peroxidase) and anti-Tg (anti-thyroglobulin) antibody tests in the monitoring of autoimmune thyroid disease.
Specific autoantibodies (AChR, MuSK, Lrp4) should not be required as a profile when myasthenia gravis is suspected, but the initial test is represented only by anti-AchR antibodies. The determination of anti-Musk antibodies should be reserved for anti-AChR negative patients, while that of anti-Lrp4 antibodies should be limited to anti-AChR and anti-MuSK negative patients.
Invasive endoscopic investigation with multiple biopsies should not be performed in all patients suspected of autoimmune gastritis but only in those presenting with alteration of serum markers of gastric function (pepsinogen I and II, gastrin 17) and/or antibodies against gastric parietal cells (PCA) and anti-intrinsic factor (IFA). For the determination of PCA and IFA, the use of quantitative immunometric methods is preferable.
The search for anti-insular cell antibodies (ICA) and anti-insulin antibodies (IAA) should not be performed in the case of suspected late-onset autoimmune diabetes (LADA) or gestational diabetes mellitus. Search instead simultaneously for anti-GAD, anti-IA2 and anti-ZnT8 antibodies.

released: 1 November 2018
last updated: 1 November 2018

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How this list was created

In November 2017, the SIPMeL Study Group in Autoimmunology (GdS-AI) organized a national conference in Santa Margherita Ligure to formulate and discuss some proposals regarding procedures at greater risk of inappropriateness in the field of autoimmune laboratory diagnostics. Of the 19 proposals presented by five working groups and submitted to the evaluation by televoting and discussion in the hall with the participants, five were chosen and approved. In the following months, additional comments and proposals were collected. The National Council has approved them.

 

5 recommendations - first list from EVIDENCE BASED LABORATORY Medicine Study Group


released: 1 April 2017
last updated: 1 September 2023

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How this list was created

In 2015 at the 1st SIPMeL National Congress, a working group developed a proposal for a list of the five procedures with the highest risk of inappropriateness. The list was discussed and approved. In the following months additional comments and proposals were gathered; no procedure reached greater consensus than the five originally listed. The National Council approved them. In 2023, the EBLM Working Group (WG) of SIPMeL was tasked to evaluate whether the first 5 SIPMeL recommendations of 2017 were still valid and, if they were, to update the bibliography. The WG proceeded with the update; the updated list was approved by the National President on June 15, 2023 and was sent to Choosing Wisely for evaluation.

5 recommendations from ENDOCRINOLOGY AND METABOLIC DISEASES Study Group


released: 1 November 2016
last updated: 1 May 2024

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How this list was created

SIPMeL Endocrinology and Metabolic Diseases Study Group (SG-EMD) edited the list of five practices at risk of inappropriateness issued in October 2016 and updated in 2018. All members of the SG assessed the timeliness of the recommendations starting at the 20 October 2023 meeting. A select group took charge of checking whether more current and relevant articles had been published between 2016 and 2023 and prepared a document to which the entire SG contributed. The final list of five updated recommendations was approved by all SG-EMD members, the president of SIPMeL and the steering group of Choosing Wisely Italy.

About this society:

The Italian Society of Clinical Pathology and Laboratory Medicine (SIPMeL) is a national medical/scientific association of professionals working in clinical laboratories. Founded in 1986 under the name SIMeL (Italian Society of Laboratory Medicine), the society has about 1,000 members. As of Oct. 29, 2014, SIMeL changed its name to SIPMeL The structure of the society is federal in nature, and includes three professional components: physicians, graduate scientific specialists (DSLBs) and biomedical laboratory technicians (STLBs). It is the responsibility of the Society to develop and disseminate the professional operating standards on which laboratory “good practice” depends. Training activities recognize educational credits to participants, in accordance with the Continuing Medical Education Program of the Ministry of Health. Scientific research and training activities are promoted and maintained by 22 study groups. https://www.sipmel.it/it/