The Endocrine Society of Australia has published its top 5 list of ‘do-not-do’ interventions and practices.

The list was published as part of the EVOLVE program,  a physician-led initiative that encourages each medical specialty to think about the clinical circumstances in which some of their practices – whether medical tests, procedures or interventions – should have their indications or value questioned and discussed by physicians.

The program is run by the RACP and is part of the wider ‘Choosing Wisely’ initiative.

ESA’s top 5 low-value practices and interventions: 

1. Don’t routinely order a thyroid ultrasound in patients with abnormal thyroid function tests if there is no palpable abnormality of the thyroid  gland.

2. Don’t prescribe testosterone therapy unless there is evidence of proven testosterone deficiency.

3. Do not measure insulin concentration in the fasting state or during an oral glucose tolerance test to assess insulin sensitivity

4. Avoid multiple daily glucose self-monitoring in adults with stable type 2 diabetes on agents that do not cause hypoglycaemia.

5. Don’t order a total or free T3 level when assessing thyroxine dose in hypothyroid patients.