Why the study?
To review practices that have become common in hospital care but may provide little value to patients, serving as a starting place for discussion on HIT testing in low probability patients.
HIT testing with ELISA should not be performed in patients with a low pretest probability (4T's score ≤3) to avoid false-positive results, unnecessary healthcare costs, and bleeding risks associated with alternative anticoagulants.
Answers are grounded in this paper and cite their sources.
May support avoiding ELISA testing in low 4T's patients to reduce costs; leaves open prospective validation.
Inspired by the ABIM Foundation's Choosing Wisely® campaign, the “Things We Do for No Reason” series reviews practices which have become common parts of hospital care but which may provide little value to our patients. Practices reviewed in the TWDFNR series do not represent “black and white” conclusions or clinical practice standards, but are meant as a starting place for research and active discussions among hospitalists and patients. We invite you to be part of that discussion.
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Li et al. (2019) conducted a review in Heparin-induced thrombocytopenia. HIT ELISA testing vs. Clinical assessment (4T's score) was evaluated.
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