Choosing Wisely's Treatments, Tests that Pediatric Rheumatologists and Patients Should Question

Report in The Rheumatologist (the ACR's member publication) on the ACR's pediatric-rheumatology Choosing Wisely Top Five list. It advises against ordering autoantibody panels without a positive ANA and evidence of rheumatic disease, and against repeating a confirmed positive ANA in established juvenile idiopathic arthritis or SLE. Candidate notes: Do not order autoantibody panels unless the patient has a positive ANA and evidence of rheumatic disease Do not repeat a confirmed positive ANA in patients with established JIA or SLE: once positive, ANA very likely remains positive Current evidence does not suggest that changes in ANA or titer over time reflect an individual patient's disease activity or course Limits noted in the record: News-style summary of the list-development process, not the guideline text itself Recommendations rest on expert consensus and member survey rather than randomized trials; pediatric scope, not generalizable to adult testing decisions A positive ANA is not a diagnosis. Claims in this record are not verified.

A positive ANA is not a diagnosis. Claims in this record are not verified.

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