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2nd priority = Boss room
3rd priority (if at all) = Shops (compass)/Sin rooms
4th priority (if at all) = "Arenas"
don't look for secret rooms too much, don't go to the arcade unless you need to really get some hearts or keys.
press and hold "R" in the 1st section of the basement/cellar to "re-seed" it. repeat until there is a sin room or an item room next to your starting spot. See what it is, if it is garbage, you may want to "re-seed" again, because you might have hard time getting to speed in terms of damage. If you get anything that increases your clearing speed, you're set for a potentially good run.
If possible, avoid "curse of the lab".