AMSSM Releases List of Commonly Used Sports Medicine Tests and Procedures to Question

As Part of Choosing Wisely® Campaign

Released: 5-Apr-2014 9:00 AM EDT
Source Newsroom: American Medical Society for Sports Medicine
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Newswise — NEW ORLEANS, La. – The American Medical Society for Sports Medicine (AMSSM) today released a list of specific tests and procedures that are commonly ordered but not always necessary in sports medicine as part of Choosing Wisely®, 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.

AMSSM’s list identified the following five recommendations:
• Avoid ordering a brain CT or brain MRI to evaluate an acute concussion unless there are progressive neurological symptoms, focal neurological findings on exam or there is concern for a skull fracture.
• Avoid ordering an abdominal ultrasound examination routinely in athletes with infectious mononucleosis.
• Don’t prescribe oral contraceptive pills as initial treatment for patients with amenorrhea or menstrual dysfunction due to the female athlete triad (defined as low energy availability with or without disordered eating, menstrual dysfunction and low bone mineral density).
• Avoid ordering a knee MRI for a patient with anterior knee pain without mechanical symptoms or effusion unless the patient has not improved following completion of an appropriate functional rehabilitation program.
• Avoid recommending knee arthroscopy as initial management for patients with degenerative meniscal tears and no mechanical symptoms.

"In the spirit of fostering excellence in the care and safety of our athletes and patients, AMSSM physicians value the opportunity to engage patients in conversations that address evidence-based care, shared decision making, and unnecessary and/or harmful interventions,” said Christopher Madden, MD, incoming president of the AMSSM. “AMSSM appreciates the importance of quality initiatives and the principles of the Triple Aim - improving patient and population health, enhancing patient experiences and outcomes, and reducing unneeded cost in healthcare. The Choosing Wisely measures we released today and our relationship with the campaign are another valuable step in the right direction for our patients.”

The AMSSM Choosing Wisely list was developed after months of careful consideration and review, using the most current evidence about management and treatment options. For each item, evidence was reviewed from peer-reviewed literature and several sports medicine consensus statements. The goal was to identify common topics in the practice of sports medicine that, supported by a review of the literature, would lead to significant health benefits and a reduction of common procedures that can be unnecessary or cause harm. The list was initially generated and drafted by AMSSM’s Quality Measures Subcommittee and then edited and approved by AMSSM’s Practice and Policy Committee and the Board of Directors.

“AMSSM has shown tremendous leadership by releasing its list of tests and procedures they say are commonly done in sports medicine, but aren’t always necessary,” said Richard J. Baron, MD, president and CEO of the ABIM Foundation. “The content of this list and all of the others developed through this effort are helping physicians and patients across the country engage in conversations about what care they need, and what we can do to reduce waste and overuse in our health care system.”

To date, nearly 100 national and state medical specialty societies, regional health collaboratives and consumer partners have joined the conversations about appropriate care. With the release of these new lists, the campaign will have covered more than 250 tests and procedures that the specialty society partners say are overused and inappropriate, and that physicians and patients should discuss.

The campaign also continues to reach millions of consumers nationwide through a stable of consumer and advocacy 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
• 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
• The Leapfrog Group
• Union Plus
• Wikipedia

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

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About the AMSSM: AMSSM is a multi-disciplinary organization of 2,500 sports medicine physicians dedicated to education, research, advocacy and the care of athletes of all ages. The majority of AMSSM members are primary care physicians with fellowship training and added qualification in sports medicine who then combine their practice of sports medicine with their primary specialty. AMSSM includes members who specialize solely in non-surgical sports medicine and serve as team physicians at the youth level, NCAA, NFL, MLB, NBA, WNBA, MLS and NHL, as well as with Olympic teams. By nature of their training and experience, sports medicine physicians are ideally suited to provide comprehensive medical care for athletes, sports teams or active individuals who are simply looking to maintain a healthy lifestyle. www.amssm.org

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 www.abimfoundation.org, read our blog blog.abimfoundation.org, 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 www.ChoosingWisely.org.


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