Recommendations for Clinical Biochemistry
Choosing Wisely is a global initiative that seeks to encourage both doctors and patients to have a conversation about the value of treatments. The below recommendations for clinical biochemistry are the result of a Choosing Wisely consultation involving the College.
1. Unless a patient is at increased risk of prostate cancer because of race or family history, PSA testing does not necessarily lead to a longer life.
Patient information/decision aids
Evidence/guidance
- NICE Clinical Knowledge Summary: PSA testing
- Prostate Cancer UK information page on the PSA test
- Public Health England’s Prostate Cancer Risk Management Programme materials
2. Calcium testing is used when there are symptoms of kidney stones, bone disease or nerve-related disorders; but it is not necessary to test less that three months after the previous test except in acute conditions, during major surgery or in critically ill patients when tests should not be made more often than every 48 hours.
3. Use statins in appropriate patients.
Evidence/guidance
- NICE Guidance: Cardiovascular disease: risk assessment and reduction, including lipid modification
- SIGN 149: Risk estimation and the prevention of cardiovascular disease.
- Collins R et al. Interpretation of the evidence for the efficacy and safety of stain therapy. Lancet 2016;388:2532–2561
- Mancini GB et al. Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Consensus Working Group Update. Can J Cardiol 2016;32:S35–65.
Patient information/decision aids