Five common errors to avoid in clinical practice: the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) Choosing Wisely Campaign

  • Elisa StasiEmail author
  • Andrea Michielan
  • Gaetano Cristian Morreale
  • Alessandro Tozzi
  • Ludovica Venezia
  • Francesco Bortoluzzi
  • Omero Triossi
  • Marco Soncini
  • Gioacchino Leandro
  • Giuseppe Milazzo
  • Andrea Anderloni


Modern medicine provides almost infinite diagnostic and therapeutic possibilities if compared to the past. As a result, patients undergo a multiplication of tests and therapies, which in turn may trigger further tests, often based on physicians’ attitudes or beliefs, which are not always evidence-based. The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) adhered to the Choosing Wisely Campaign to promote an informed, evidence-based approach to gastroenterological problems. The aim of this article is to report the five recommendations of the AIGO Choosing Wisely Campaign, and the process used to develop them. The AIGO members’ suggestions regarding inappropriate practices/interventions were collected. One hundred and twenty-one items were identified. Among these, five items were selected and five recommendations were developed. The five recommendations developed were: (1) Do not request a fecal occult blood test outside the colorectal cancer screening programme; (2) Do not repeat surveillance colonoscopy for polyps, after a quality colonoscopy, before the interval suggested by the gastroenterologist on the colonoscopy report, or based on the polyp histology report; (3) Do not repeat esophagogastroduodenoscopy in patients with reflux symptoms, with or without hiatal hernia, in the absence of different symptoms or alarm symptoms; (4) Do not repeat abdominal ultrasound in asymptomatic patients with small hepatic haemangiomas (diameter < 3 cm) once the diagnosis has been established conclusively; (5) Do not routinely prescribe proton pump inhibitors within the context of steroid use or long-term in patients with functional dyspepsia. AIGO adhered to the Choosing Wisely Campaign and developed five recommendations. Further studies are needed to assess the impact of these recommendations in clinical practice with regards to clinical outcome and cost-effectiveness.


Appropriateness Choosing wisely Overdiagnosis Overtreatment Recommendations 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent



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Copyright information

© Società Italiana di Medicina Interna 2018

Authors and Affiliations

  • Elisa Stasi
    • 1
    Email author
  • Andrea Michielan
    • 2
  • Gaetano Cristian Morreale
    • 3
  • Alessandro Tozzi
    • 4
  • Ludovica Venezia
    • 5
  • Francesco Bortoluzzi
    • 6
  • Omero Triossi
    • 7
  • Marco Soncini
    • 8
  • Gioacchino Leandro
    • 1
  • Giuseppe Milazzo
    • 9
  • Andrea Anderloni
    • 10
  1. 1.Gastroenterology UnitNational Institute of Gastroenterology “S. De Bellis” Research HospitalCastellana GrotteItaly
  2. 2.Gastroenterology and Digestive Endoscopy UnitOspedale Santa ChiaraTrentoItaly
  3. 3.Gastroenterology UnitPalermoItaly
  4. 4.Gastroenterology UnitSan Giuseppe HospitalEmpoliItaly
  5. 5.Gastroenterology UnitAOU Città della Salute e della Scienza TurinTurinItaly
  6. 6.Gastroenterology UnitVeniceItaly
  7. 7.Gastroenterology UnitAUSL RomagnaRavennaItaly
  8. 8.Gastroenterology UnitSan Carlo Borromeo HospitalMilanItaly
  9. 9.Department of MedicineOspedale Vittorio Emanuele IIISalemiItaly
  10. 10.Digestive Endoscopy UnitHumanitas Research HospitalMilanItaly

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