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

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Abstract

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.

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Authors and Affiliations

  1. Gastroenterology Unit, National Institute of Gastroenterology “S. De Bellis” Research Hospital, Via Turi 27, 70013, Castellana Grotte, Ba, Italy

    Elisa Stasi & Gioacchino Leandro

  2. Gastroenterology and Digestive Endoscopy Unit, Ospedale Santa Chiara, Trento, Italy

    Andrea Michielan

  3. Gastroenterology Unit, Ospedali Riuniti Villa Sofia-Vincenzo Cervello, Palermo, Italy

    Gaetano Cristian Morreale

  4. Gastroenterology Unit, San Giuseppe Hospital, Empoli, Italy

    Alessandro Tozzi

  5. Gastroenterology Unit, AOU Città della Salute e della Scienza Turin, Turin, Italy

    Ludovica Venezia

  6. Gastroenterology Unit, ULSS 12, Venice, Italy

    Francesco Bortoluzzi

  7. Gastroenterology Unit, AUSL Romagna, Ravenna, Italy

    Omero Triossi

  8. Gastroenterology Unit, San Carlo Borromeo Hospital, Milan, Italy

    Marco Soncini

  9. Department of Medicine, Ospedale Vittorio Emanuele III, Salemi, Tp, Italy

    Giuseppe Milazzo

  10. Digestive Endoscopy Unit, Humanitas Research Hospital, Milan, Italy

    Andrea Anderloni

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  1. Elisa Stasi
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Correspondence to Elisa Stasi.

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Stasi, E., Michielan, A., Morreale, G.C. et al. Five common errors to avoid in clinical practice: the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) Choosing Wisely Campaign. Intern Emerg Med 14, 301–308 (2019). https://doi.org/10.1007/s11739-018-1992-x

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