Blood Journal
Leading the way in experimental and clinical research in hematology

The ASH Choosing Wisely® Campaign: five hematologic tests and treatments to question

  1. Lisa K. Hicks1,*,
  2. Harriet Bering2,
  3. Kenneth R. Carson3,
  4. Judith Kleinerman4,
  5. Vishal Kukreti5,
  6. Alice Ma6,
  7. Brigitta U. Mueller7,
  8. Sarah H. O'Brien8,
  9. Marcelo Pasquini9,
  10. Ravindra Sarode10,
  11. Lawrence Solberg Jr.11,
  12. Adam E. Haynes12, and
  13. Mark A. Crowther13
  1. 1 University of Toronto, St. Michael's Hospital, Toronto, ON, Canada;
  2. 2 Harvard Vanguard Medical Associates, Beverley, MA, United States;
  3. 3 Washington University in St. Louis, MO, United States;
  4. 4 Medical Specialists of Taunton, Tauton, MA, United States;
  5. 5 University of Toronto, University Health Network, Toronto, ON, Canada;
  6. 6 University of North Carolina, Chapel Hill, NC, United States;
  7. 7 Baylor College of Medicine, Houston, TX, United States;
  8. 8 Nationwide Children's Hospital, Columbus, OH, United States;
  9. 9 Medical College of Wisconsin, Milwaukee, WI, United States;
  10. 10 UT Southwestern Medical Center, Dallas, TX, United States;
  11. 11 Mayo Clinic, Jacksonville, FL, United States;
  12. 12 Adam Haynes Consulting, Hamilton, ON, Canada;
  13. 13 McMaster University, Hamilton, ON, Canada
  1. * Corresponding author; email: hicksl{at}smh.ca
This article has an Erratum 123(21):3364

Abstract

Choosing Wisely® is a medical stewardship and quality improvement initiative led by the American Board of Internal Medicine Foundation in collaboration with leading medical societies in the United States. The American Society of Hematology (ASH) is an active participant in the Choosing Wisely® project. Using an iterative process and an evidence-based method ASH has identified five tests and treatments that in some circumstances are not well supported by evidence and which in certain cases involve a risk of adverse events and financial costs, with low likelihood of benefit. The ASH Choosing Wisely® recommendations focus on avoiding liberal red blood cell transfusion, avoiding thrombophilia testing in adults in the setting of transient major thrombosis risk factors, avoiding IVC filter usage except in specified circumstances, avoiding the use of plasma or prothrombin complex concentrate (PCC) in the non-emergent reversal of vitamin K antagonists, and limiting routine CT surveillance following curative-intent treatment of non-Hodgkin lymphoma. We recommend that clinicians carefully consider anticipated benefits of the identified tests and treatments before performing them.

  • Submitted July 30, 2013.
  • Accepted September 9, 2013.