Toxicology Societies Release List of Commonly Used Tests and Treatments to Question As Part of Choosing Wisely® Campaign - September 26, 2013
posted on 5:25 AM, June 26, 2014
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The American College of Medical Toxicology and the American Academy of Clinical
Toxicology encourage physician and patient conversations about evidence-based medicine by
identifying five treatments or tests to question, highlighting the potentially unnecessary and
sometimes harmful care that can result.
Phoenix, Arizona (PRWEB) September 26, 2013 -- The American College of Medical Toxicology (ACMT) and
American Academy of Clinical Toxicology (AACT) jointly released a list of specific treatments, tests and
procedures that are commonly used, rarely necessary, and potentially harmful 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
The joint ACMT and AACT list identified the following five recommendations:
1. Don’t use homeopathic medications, non-vitamin dietary supplements or herbal supplements as treatments
for disease or preventive health measures.
2. Don’t administer a chelating agent prior to testing urine for metals, a practice referred to as‘provoked’ urine
3. Don’t order heavy metal screening tests to assess non-specific symptoms in the absence of excessive
exposure to metals.
4. Don’t recommend chelation except for documented metal intoxication which has been diagnosed using
validated tests in appropriate biological samples.
5. Don’t remove mercury-containing dental amalgams (fillings).
According to Suzanne White, MD, President of ACMT, “Through its quality educational programs and support
of board certification, ACMT has been a leader in promoting the highest standards of evidence-based care for
all patients. By joining the Choosing Wisely campaign, we hope to spark thoughtful conversations between
patients and their physicians about unnecessary tests or treatments. This is key to protecting the public from
practices that are harmful or inappropriate.” Robert S. Hoffman, MD, FAACT, FACMT, FRCP Edin, President
of AACT adds, “As Toxicologists, we strive to provide the best possible evaluation and treatment based on
existing scientific evidence and share in our responsibility to limit skyrocketing health care costs. We favor the
right care over more care and hope these five statements will allow patients to have more informed
conversations with all of their health care providers.”
The ACMT and AACT joint list was developed after careful consideration and review of the most current
evidence about diagnosis, management, and treatment options in toxicology care. List development was led by
a Choosing Wisely® Work Group, with members representing various practice settings within the field of
Medical and Clinical Toxicology, including ambulatory, acute, and population-based practice. The Work Group
solicited input from members of both societies, as well as from leaders within the field. All feedback was
reviewed and the final list determined based on a review of scientific evidence, relevance to the specialty, and
the greatest opportunity to improve care, reduce cost, and reduce harm to patients. The final list was approved
by the ACMT Board of Directors and the AACT Board of Trustees.
The release of this list kicks off the North American Congress of Clinical Toxicology annual meeting, where
specialists in clinical toxicology and poisoning treatment will gather to review the latest scientific research and
developments in diagnosis, treatment, and prevention of human poisoning. The meeting will be held in Atlanta,
Georgia at the Hyatt Regency.
For more information on the ABIM Foundation’s Choosing Wisely campaign, including lists from more than
30 medical specialty societies, visit www.choosingwisely.org.
ACMT is a professional, nonprofit association of physicians with recognized expertise in medical toxicology.
The College is dedicated to advancing the science and practice of medical toxicology through a variety of
activities. AACT is a multidisciplinary organization uniting scientists and clinicians in the advancement of
research, education, prevention, and treatment of diseases caused by chemicals, drugs, and toxins.