title: [Choosing wisely: the Top 5 list of the Italian Association of Hospital Cardiologists (ANMCO)].
abstract: In recent years, a progressive increase in the number of medical diagnostic and interventional procedures has been observed, namely in cardiology. A significant proportion of them appear inappropriate, i.e. potentially redundant, harmful, costly, and useless. Recently, the document Medical Professionalism in the New Millennium: A Physician Charter, the American Board of Internal Medicine (ABIM) Foundation Putting the Charter into Practice program, JAMA's Less Is More and BMJ's Too Much Medicine series, and the American College of Physicians' High-Value, Cost-Conscious Care initiatives, have all begun to provide direction for physicians to address pervasive overuse in health care. In 2010, the Brody's proposal to scientific societies to indicate the five medical procedures at high inappropriateness risk inspired the widely publicized ABIM Foundation's Choosing Wisely campaign. As part of Choosing Wisely, each participating specialty society has created lists of Things Physicians and Patients Should Question that provide specific, evidence-based recommendations physicians and patients should discuss to help make wise decisions about the most appropriate individual care. In Italy, Slow Medicine launched the analogue campaign Fare di più non significa fare meglio. The Italian Association of Hospital Cardiologists (ANMCO) endorsed the initiative by recognizing the need to optimize available resources, reduce costs and avoid unnecessary cardiovascular assessments, thereby enhancing the more efficient care delivery models. An ad hoc ANMCO Working Group prepared a list of five cardiac procedures that seem inappropriate for routine use in our country and, after an internal revision procedure, these are presented here.
authors.forename: Marco
authors.initials: M
authors.lastname: Bobbio
authors.forename: Maurizio G
authors.initials: MG
authors.lastname: Abrignani
authors.forename: Pasquale
authors.initials: P
authors.lastname: Caldarola
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Casolo
authors.forename: Francesco
authors.initials: F
authors.lastname: Fattirolli
authors.forename: Domenico
authors.initials: D
authors.lastname: Gabrielli
authors.forename: Massimo
authors.initials: M
authors.lastname: Grimaldi
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Mazzotta
authors.forename: Loris
authors.initials: L
authors.lastname: Roncon
authors.forename: Quinto
authors.initials: Q
authors.lastname: Tozzi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vallebona
mesh_terms: D002309:Cardiology / Q000191:economics / Q000592:standards; D002317:Cardiovascular Agents / Q000191:economics / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000628:therapy*; D017046:Cost Savings; D003657:Decision Making; D003952:Diagnostic Imaging / Q000191:economics / Q000706:statistics & numerical data; D003935:Diagnostic Techniques, Cardiovascular / Q000191:economics / Q000706:statistics & numerical data; D019468:Disease Management; D004452:Echocardiography / Q000706:statistics & numerical data; D015716:Electrocardiography, Ambulatory / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005080:Exercise Test / Q000706:statistics & numerical data; D005194:Family Practice / Q000592:standards; D006300:Health Services Misuse / Q000517:prevention & control*; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D007388:Internal Medicine / Q000592:standards; D007558:Italy; D009313:National Health Programs / Q000592:standards; D010372:Pediatrics / Q000592:standards; D012955:Societies, Medical / Q000592:standards; D019564:Unnecessary Procedures / Q000191:economics
chemical_list: D002317:Cardiovascular Agents