HFHT's Practising Wisely Newsletter
For clinicians, by clinicians.
Issue 24: Do Away With the CBC!
May 23, 2017

No, we are not proposing to shut down of our national broadcaster. However, we need to look at the use of the Complete Blood Count (CBC) as a part of screening or a Periodic Health Review.

The OCFP (Ontario College of Family Physicians) has circulated as part of their Tools for Practice a summary about CBC screening cleverly called “CBC (Confusing Broad Check) for Screening?". We get to the main point of the summary below:

Clinical Question: What is the evidence for screening with a CBC (Complete Blood Count) in asymptomatic, non-pregnant adults?

Bottom Line: CBC or its components should NOT be ordered for screening asymptomatic non-pregnant adults as it does not reduce mortality. When CBC is tested routinely without cause, up to 11% are abnormal but <1% require management change. It is unclear which patients benefit and serious disease is virtually never found.  

The web link, found in the Quick Links section of this newsletter, contains a more detailed review of the evidence.

Our committee is looking at a simple QI exercise that we would apply to our own practices with the aim of reducing the ordering of “routine CBC’s”. Stay tuned for more info!

Choosing Wisely Talks
Overutilization in Lab Medicine: Opportunities and Challenges
Webinar - June 1, 2017 (12:00-1:00 p.m.)

This month’s Choosing Wisely webinar will be about repetitive ‘routine’ blood testing (RBT) in the hospital. Physicians from St. Michael's Hospital in Toronto will talk about a pilot project that has resulted in a 20% reduction in RBT across three wards. Check out our Quick Links section so you can get all the details.
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