AAP Expands Choosing Wisely With Rheumatology Recommendations

The American Academy of Pediatrics has expanded its Choosing Wisely campaign with 5 new practices clinicians should avoid in rheumatology.

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Fellow members of the Academy’s Section on Rheumatology were polled to create a list of practices that “resulted in misuse of laboratory studies and resources.”  The list was broken down into 5 statements addressing the most common misconceptions when encountering pediatric autoimmune conditions.

The 5 statements are as follows:

1. Do not prescribe opioids for the treatment of pain in patients with autoimmune conditions.
2. Antinuclear antibody and other autoantibody testing should not be ordered on children unless there is a strong suspicion of autoimmune disease.
3. Without exposure history, Lyme disease should not be tested for as the cause of musculoskeletal symptoms.
4. Periodic fever syndrome genetic panels should not be sent prior to infectious and oncologic work up or in patients without evidence of recurrent fever.
5. Rheumatoid factor should not be ordered alone or as part of a panel or cascade in children to evaluate for rheumatologic disease.

—Michael Potts

Reference:

American Academy of Pediatrics – Section on Rheumatology. Five things physicians and patients should question. Published August 6, 2019. Accessed August 7, 2019. http://www.choosingwisely.org/societies/american-academy-of-pediatrics-section-on-rheumatology/.