In an effort to reduce waste and needless testing in healthcare, "Choose Wisely" is a public health initiative recently launched by the American Board of Internal Medicine. Using "top five" lists, the "Choose Wisely" series presents some of the most over used and least helpful medical tests and procedures found in the healthcare field. As the first in this series, "Five Things Physicians and Patients Should Question" was released late last weekend and focuses on the areas of asthma, allergies and other immune system disorders.

From this initial list, the top two items were to avoid using IgG or battery of IgE tests as the primary basis for diagnosing an allergy, and to stop prescribing antibiotics for uncomplicated acute rhinosinusitis. These two things touch issues we've highlighted in recent months.

Immunoglobulin G (IgG) and Immunoglobulin E (IgE) tests alone are not accurate in determining an allergy, and overreliance on these tests can often lead to false positives. They are convenient, easy, and give you answers, but unfortunately, those answers aren't always accurate. Instead of general testing, the "Choose Wisely" top-five suggests a doctor take into account the patients history and physical exam records, then administer a specific IgE test based on these factors. Combined, these three pieces form a more complete picture of the puzzle and can dramatically reduce the occurrence of false positives in allergy testing.

Over prescription of antibiotics for sinusitis is something we touched recently with this post. For quite some time it has been the theory that not only are they ineffective in most cases, but overuse, in general, in directly leading to their ineffectiveness against modern germs. Most acute sinus infections are viral in nature, and like we learned in high school biology, antibiotics are ineffective against viruses. Additionally, most viral sinus infections run their course in a couple weeks.

In all, there are five recommendations put forth that deal with allergies, asthma or immune disorders. You can find the full list here. We encourage anyone who suffers from allergies, asthma or related disorder to take a look and see if any apply to you. Then the next time you visit your allergist, ENT or doctor, discuss them and see if there are ways to curb certain tests or treatments which may not offer much benefit.