Choosing wisely: the American College of Rheumatology's Top 5 list of things physicians and patients should question

ACR Choosing Wisely Top 5 paper. Includes the recommendation not to test ANA subserologies without a positive ANA and clinical suspicion of immune-mediated disease, noting rare exceptions such as anti-Jo-1 or occasionally anti-SSA. Candidate notes: Do not test ANA subserologies without a positive ANA and clinical suspicion of immune-mediated disease. Subserologies listed include antibodies to dsDNA, Sm, RNP, SSA, SSB, Scl-70, and centromere. These tests are usually negative if ANA is negative. Exceptions include anti-Jo-1 in some forms of myositis, or occasionally anti-SSA in lupus or Sjogren syndrome. Broad autoantibody testing should be avoided; choice of autoantibodies should be guided by the specific disease under consideration. Limits noted in the record: 2013 Choosing Wisely list; ChoosingWisely.org no longer hosts the detailed clinician list (campaign wound down). 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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