Choosing Wisely:

Don’t perform population-based screening for 25-OH-vitamin D deficiency.

Rationale and Comments: Vitamin D deficiency is common in many populations, particularly in patients at higher latitudes, during winter months, and in those with limited sun exposure. Over-the-counter vitamin D supplements and increased summer sun exposure are sufficient for most otherwise healthy patients. Laboratory testing is appropriate in higher risk patients when results will be used to institute more aggressive therapy (e.g., osteoporosis, chronic kidney disease, malabsorption, some infections, obese individuals).
Sponsoring Organizations:
  • American Society for Clinical Pathology
  • Sources:
  • Endocrine Society guidelines
  • Disciplines:
  • Endocrinologic
  • Preventive Medicine
  • References: • Sattar N, et al. Increasing requests for vitamin D measurement: costly, confusing, and without credibility. Lancet. 2012;379:95-6.
    • Bilinski K, et al. The rising cost of vitamin D testing in Australia: time to establish guidelines for testing. Med J Aust. 2012;197(2):90.
    • Lu C. Pathology consultation on vitamin D testing: clinical indications for 25(OH) vitamin D measurement [letter to the editor]. Am J Clin Pathol. 2012;137:831.
    • Holick M, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-30.

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