Under the leadership of the Canadian Thoracic Society, we are excited to announce the release of 6 new recommendations of tests, treatments or procedures that are overused in respiratory medicine:
- Don’t initiate long-term maintenance inhalers in stable patients with suspected COPD if they have not had confirmation of post-bronchodilator airflow obstruction with spirometry.
- Don’t perform CT screening for lung cancer among patients at low risk for lung cancer.
- Don’t perform chest computed tomography (CT angiography) or ventilation-perfusion scanning to evaluate for possible pulmonary embolism in patients with a low clinical probability and negative results of a highly sensitive D-dimer assay.
- Don’t treat adult cough with antibiotics even if it lasts more than 1 week, unless bacterial pneumonia is suspected (mean viral cough duration is 18 days).
- Don’t initiate medications for asthma (e.g., inhalers, leukotriene receptor antagonists, or other) in patients ≥ 6 years old who have not had confirmation of reversible airflow limitation with spirometry, and in its absence, a positive methacholine or exercise challenge test, or sufficient peak expiratory flow variability.
- Don’t use antibiotics for acute asthma exacerbations without clear signs of bacterial infection.
See Six Things Physicians and Patients Should Question in Respiratory Medicine to view the full list, including a rationale and references for each recommendation.