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Group aims to encourage physician and patient conversations by identifying five tests or procedures to question, highlighting potentially unnecessary — sometimes harmful — care in urology

LINTHICUM, MD, February 21, 2013– The American Urological Association (AUA) today released a list of specific tests or procedures that are commonly ordered but not always necessary in urology as part of the Choosing Wisely® campaign, an initiative of the ABIM Foundation. The list identifies five targeted, evidence-based recommendations that can support conversations between patients and physicians about what care is really necessary.

The AUA’s list identified the following five recommendations:

  • A routine bone scan is unnecessary in men with low-risk prostate cancer.
  • Do not prescribe testosterone to men with erectile dysfunction who have normal testosterone levels.
  • Do not order creatinine or upper-tract imaging for patients with benign prostatic hyperplasia (BPH).
  • Do not treat an elevated PSA with antibiotics for patients not experiencing other symptoms.
  • Do not perform ultrasound on boys with cryptorchidism.

 “The AUA’s participation in the Choosing Wisely campaign affirms our belief in providing the finest care possible while adhering to the highest standards of medicine,” said AUA Health Policy Chair Dr. David F. Penson, MD, MPH. “Through our well-regarded guidelines process and burgeoning measure development system, the AUA strives to instruct urologists and other healthcare providers on the proper way to provide urologic care. Choosing Wisely is another venue to share critical information with both healthcare professionals and patients to help initiate important conversations about treatment options.”

All the lists released today as part of the Choosing Wisely campaign were developed by individual specialty societies after months of careful consideration and review. Using the most current evidence about management and treatment options within their specialty, the societies believe the recommendations can make a significant impact on patient care, safety and quality.

Following the AUA Board of Director’s decision in May 2012 to participate in Choosing Wisely, a task force, led by Dr. Penson, was created.  Based the recommendations provided by ABIM, the task force focused on tests, treatments and services that are primarily provided by urologists and concentrated on reducing waste and overuse.  Additionally, they considered the AUA’s guidelines to ensure that the list was evidence-based.  Through this methodical and science-based approach, the task force drafted the AUA’s top five list which was reported to and approved by the AUA Board of Directors.

Releasing lists along with the AUA today are 16 other organizations representing more than 350,000 physicians, nurses, pathologists, radiologists and other health care professionals. They are:

•             American Academy of Family Physicians*
•             American Academy of Hospice and Palliative Medicine
•             American Academy of Neurology
•             American Academy of Ophthalmology
•             American Academy of Otolaryngology—Head and Neck Surgery
•             American Academy of Pediatrics
•             American College of Obstetricians and Gynecologists
•             American College of Rheumatology
•             American Geriatrics Society
•             American Society for Clinical Pathology
•             American Society of Echocardiography
•             Society of Cardiovascular Computed Tomography
•             Society of Hospital Medicine
•             Society of Nuclear Medicine and Molecular Imaging
•             Society of Thoracic Surgeons
•             Society for Vascular Medicine

*Releasing a second list

In April 2012, nine medical specialty societies each released lists as part of the Choosing Wisely campaign. To date more than 130 tests and procedures to question have been released as part of the campaign and the specialty societies are now undertaking considerable efforts to share the recommendations with their collective membership of more than 725,000 physicians.

The campaign is also reaching millions of consumers nationwide through a stable of consumer partners, led by Consumer Reports—the world’s largest independent product-testing organization—which has worked with the ABIM Foundation to distribute patient-friendly resources for consumers and physicians to engage in these important conversations. Choosing Wisely consumer partners include:

•             AARP
•             Alliance Health Networks
•             The Leapfrog Group
•             Midwest Business Group on Health
•             Minnesota Health Action Group
•             National Business Coalition on Health
•             National Business Group on Health
•             National Center for Farmworker Health
•             National Hospice and Palliative Care Organization
•             National Partnership for Women & Families
•             Pacific Business Group on Health
•             SEIU
•             Union Plus
•             Wikipedia

In addition, the campaign announced specialty societies who will release new lists later in 2013:

•             American Academy of Dermatology
•             American Academy of Family Physicians**
•             American Academy of Orthopaedic Surgeons
•             American College of Rheumatology*
•             American College of Surgeons
•             American College of Chest Physicians
•             American Headache Society
•             AMDA—Dedicated to Long Term Care Medicine
•             American Society of Clinical Oncology*
•             American Society for Hematology
•             American Society for Radiation Oncology
•             American Thoracic Society
•             Heart Rhythm Society
•             North American Spine Society
•             Society of General Internal Medicine

*Releasing a second list
**Releasing a third list

To learn more about Choosing Wisely and to view the complete lists and additional detail about the recommendations and evidence supporting them, visit

About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 19,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health policy.

About the ABIM Foundation: The mission of the ABIM Foundation is to advance medical professionalism to improve the health care system. We achieve this by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policy makers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit, read our blog, connect with us on Facebook or follow us on Twitter.

About Choosing Wisely:First announced in December 2011, Choosing Wisely is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources. Participating specialty societies are working with the ABIM Foundation and Consumer Reports to share the lists widely with their members and convene discussions about the physician’s role in helping patients make wise choices. Learn more at 

Wendy Waldsachs Isett, AUA