1. 1

    Do not perform a D-Dimer in patients at high risk of pulmonary embolism

  2. 2

    Do not use long term systemic corticosteroids for management of chronic obstructive pulmonary disease (COPD)

  3. 3

    Do not initiate maintenance inhalers in minimally symptomatic COPD patients with a low risk of exacerbation

  4. 4

    Do not routinely follow-up solid pulmonary nodules smaller than 6 mm detected in low-risk patients

  5. 5

    Do not perform a serum ACE for the diagnosis or monitoring of sarcoidosis


​How this list was developed

The Thoracic Society of Australia and New Zealand (TSANZ) worked with RACP’s Policy & Advocacy team as part of the Evolve program to develop a long list of low-value practices and interventions that pertain to the specialty. Through extensive research and redrafting under the guidance of the TSANZ Central Office and members of the TSANZ Board, the list was condensed to the top-5 recommendations for reducing low-value practices in adult thoracic medicine. After several rounds of internal consultations and revisions, the list of recommendations was subject to an extensive review process that involved key College societies with an interest in or professional engagement with thoracic medicine.

Per usual processes, the recommendations were then consulted with other medical colleges through Choosing Wisely Australia. Feedback received in the consultations led to further work and refinements by Policy & Advocacy and TSANZ, which approved these top-5 recommendations.