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

Hicks, Lisa K.; Bering, Harriet; Carson, Kenneth R.; Kleinerman, Judith; Kukreti, Vishal; Ma, Alice; Mueller, Brigitta U.; O’Brien, Sarah H.; Pasquini, Marcelo C.; Sarode, Ravindra; Solberg, Lawrence A.; Haynes, Adam E.; Crowther, Mark

doi:10.1182/blood-2013-07-518423

Cited by 157 publications

(95 citation statements)

References 35 publications

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“…These recommendations are in keeping with the 2012 ACCP guidelines and the ASH choosing wisely campaign. 47,72 In patients with large, symptomatic thrombosis and severe thrombocytopenia, we sometimes follow a strategy of platelet transfusions to reach a threshold of 50 000/μL to allow safer anticoagulation with heparin. There is little evidence to support this and the decision must be individualized.…”

Section: Inferior Vena Cava Filtersmentioning

confidence: 99%

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Venous thromboembolism in hematopoietic stem cell transplant recipients

Chaturvedi

Neff

Nagler

et al. 2015

Bone Marrow Transplant

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Venous thromboembolism (VTE) is an increasingly recognized problem in the post-hematopoietic stem cell transplantation (HSCT) setting, with a lack of high-quality evidence-based data to recommend best practices. Few patients with hematologic malignancies and even fewer post-HSCT patients were included in randomized trials of VTE prophylaxis and treatment. Prior VTE, GVHD, infections and indwelling venous catheters are risk factors for thrombosis. The increasing use of post-transplant maintenance therapy with lenalidomide in patients with multiple myeloma adds to this risk after autologous HSCT. These patients are also at high risk of bleeding complications because of prolonged thrombocytopenia and managing the competing risks of bleeding and thrombosis can be challenging. This review aims to provide a practical, clinician-focused approach to the prevention and treatment of VTE in the post-HSCT setting.

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Section: Inferior Vena Cava Filtersmentioning

confidence: 99%

“…48 Filters should not be used for primary prophylaxis of pulmonary embolism. [70][71][72] Retrievable filters should be removed as soon as risk of pulmonary embolism resolves or when anticoagulation can be resumed. These recommendations are in keeping with the 2012 ACCP guidelines and the ASH choosing wisely campaign.…”

Section: Inferior Vena Cava Filtersmentioning

confidence: 99%

Venous thromboembolism in hematopoietic stem cell transplant recipients

Chaturvedi

Neff

Nagler

et al. 2015

Bone Marrow Transplant

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“…The campaign identified five hematologic tests and treatments that practicing hematologists should carefully consider because-when used in the incorrect setting-these procedures may increase the cost of medical care and expose patients to potential risks with a low likelihood of benefit [1]. The recommendations were selected by the ASH Choosing Wisely® Task Force and the ASH committee after a careful review pro-1 3 cess of the recent published literature.…”

Section: Ash Choosing Wisely ® Campaign: Inferior Vena Cava Filters mentioning

confidence: 99%

Highlights of the American Society of Hematology Meeting 2013: hemostaseology

Feistritzer

Wildner

2014

memo

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Venous thromboembolism is associated with substantial morbidity and mortality. Furthermore, the subsequently indicated anticoagulation treatment puts the patient at risk of possible bleeding complications. Therefore, improving treatment strategies as well as diagnostic approaches can optimize patient care. During the 55th Annual Meeting 2013 of the American Society of Hematology the Choosing Wisely® campaign was presented. An expert committee recommends against the test for thrombophilia after venous thromboembolism occurring in the setting of major transient risk factors to avoid over treatment in these patients. Other presentations focused on the use of the direct oral anticoagulants in patients with cancer-associated thromboembolism. However, specific studies comparing direct oral anticoagulants with the state-of the art treatment with low molecular heparins in cancer-associated thromboembolism are still missing. Finally, age-adjusted cut-off levels can increase the specificity of D-Dimer in older patients. Consequently, using clinical probability assessment in the combination with age-adjusted D-dimer cut-off levels may be associated with a larger number of patients in whom pulmonary embolism can be ruled out.

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“…We adapted an existing framework developed on the basis of evidentiary rationales identified in a review of 25 societies' Choosing Wisely lists 10 and considered criteria used by other societies [11][12][13] and guidance provided by Choosing Wisely Canada.…”

Section: Criteria For Recommendation Selection and Prioritizationmentioning

confidence: 99%

Choosing wisely: The Canadian Thoracic Society's list of six things that physicians and patients should question

Gupta

Goodridge

Pakhalé

et al. 2017

Canadian Journal of Respiratory, Critical Care, and Sleep Medic

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Choosing Wisely is a campaign that aims to help clinicians and patients engage in conversations regarding unnecessary tests and treatments, in order to improve quality of care and reduce waste in healthcare. Specialty societies are asked to develop lists of commonly used tests and treatments that are not supported by evidence and/or could expose patients to unnecessary harm. The Canadian Thoracic Society appointed a 5-member Choosing Wisely Task Force to develop this list. After establishing evidence-based criteria for recommendation selection and prioritization, they generated an initial list of candidate recommendations from: 1) existing respiratory-related US and Canadian Choosing Wisely recommendations; 2) Canadian Medical Association (CMA) Patient-Oriented Evidence that Matters (POEMs TM ) rated by 10% of CMA respondents to: "… help to avoid unnecessary or inappropriate treatment, diagnostic procedures, preventative interventions or a referral…"; and 3) additional suggestions by CTS content experts. The list was serially reduced through voting by members of the Canadian Respiratory Guidelines Committee and the Task Force in three electronic Delphi processes and by members of the CTS in an online poll (members were also asked to suggest additional recommendations). Evidence reviews were performed for the top 10 recommendations. This resulted in the following CTS Choosing Wisely Top 6 List: 1) Don't initiate long-term maintenance inhalers in stable patients with suspected COPD if they have not had confirmation of post-bronchodilator airflow obstruction with spirometry; 2) Don't perform CT screening for lung cancer among patients at low risk for lung cancer; 3) Don't perform chest computed tomography (CT angiography) or ventilation-perfusion scanning to evaluate for possible pulmonary embolism in patients with a low clinical probability and negative results of a highly sensitive D-dimer assay; 4) Don't treat adult cough with antibiotics even if it lasts more than 1 week, unless bacterial pneumonia is suspected (mean viral cough duration is 18 days); 5) Don't initiate medications for asthma (e.g., inhalers, leukotriene receptor antagonists, or other) in patients 6 years old who have not had confirmation of reversible airflow limitation with spirometry, and in its absence, a positive methacholine or exercise challenge test, or sufficient peak expiratory flow variability; and 6) Don't use antibiotics for acute asthma exacerbations without clear signs of bacterial infection. This list was developed through a rigorous and novel process and addresses overuse in different areas of respiratory medicine in Canada. It can provide a starting point for a systematic implementation process targeting clinicians and patients, to the benefit of patients and the healthcare system in general. R ESUM EChoisir avec soin est une campagne qui vise a aider les cliniciens et les patients a engager un dialogue sur les tests et les traitements non n ecessaires, afin d'am eliorer les soins et r eduire la consommation inutile de r...

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

Cited by 157 publications

References 35 publications

Venous thromboembolism in hematopoietic stem cell transplant recipients

Venous thromboembolism in hematopoietic stem cell transplant recipients

Highlights of the American Society of Hematology Meeting 2013: hemostaseology

Choosing wisely: The Canadian Thoracic Society's list of six things that physicians and patients should question

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