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

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 ASH is an active participant in the Choosing Wisely® project. Using an iterative process and an evidence-based method, ASH has identified 5 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 RBC transfusion, avoiding thrombophilia testing in adults in the setting of transient major thrombosis risk factors, avoiding inferior vena cava filter usage except in specified circumstances, avoiding the use of plasma or prothrombin complex concentrate in the nonemergent reversal of vitamin K antagonists, and limiting routine computed tomography surveillance after curative-intent treatment of non-Hodgkin lymphoma. We recommend that clinicians carefully consider anticipated benefits of the identified tests and treatments before performing them.

[1]  J. Birkmeyer,et al.  Preoperative Placement of Inferior Vena Cava Filters and Outcomes After Gastric Bypass Surgery , 2010, Annals of surgery.

[2]  M. Crowther,et al.  Indications, complications, and management of inferior vena cava filters: the experience in 952 patients at an academic hospital with a level I trauma center. , 2013, JAMA internal medicine.

[3]  B Y Yeap,et al.  Value of follow-up procedures in patients with large-cell lymphoma who achieve a complete remission. , 1991, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  E. Frenkel,et al.  Poor correlation of supratherapeutic international normalised ratio and vitamin K‐dependent procoagulant factor levels during warfarin therapy , 2006, British journal of haematology.

[5]  Jason C. Fish,et al.  Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. , 2012, Chest.

[6]  Paolo Prandoni,et al.  Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. , 2012, Chest.

[7]  L. Shih,et al.  Value of surveillance computed tomography in the follow-up of diffuse large B-cell and follicular lymphomas , 2012, Annals of Hematology.

[8]  Sunil V. Rao,et al.  Red Blood Cell Transfusion: A Clinical Practice Guideline From the AABB* , 2012, Annals of Internal Medicine.

[9]  A. Auerbach,et al.  Effect of hospitalist attending physicians on trainee educational experiences: a systematic review. , 2009, Journal of hospital medicine.

[10]  D. Brenner,et al.  Computed tomography--an increasing source of radiation exposure. , 2007, The New England journal of medicine.

[11]  C. Flowers,et al.  Surveillance computed tomography scans for patients with lymphoma: is the risk worth the benefits? , 2010, Clinical lymphoma, myeloma & leukemia.

[12]  Philip S Barie,et al.  Clinical practice guideline: Red blood cell transfusion in adult trauma and critical care* , 2009, Critical care medicine.

[13]  R. Wachter.  The hospitalist movement 10 years later: life as a Swiss army knife. , 2006, MedGenMed : Medscape general medicine.

[14]  M. Lishner,et al.  Detection of relapse in non‐Hodgkin's lymphoma: Role of routine follow‐up studies , 2002, American journal of hematology.

[15]  R. Pearse,et al.  Guidelines on the management of anaemia and red cell transfusion in adult critically ill patients , 2013, British journal of haematology.

[16]  S. Miyakis,et al.  Factors contributing to inappropriate ordering of tests in an academic medical department and the effect of an educational feedback strategy , 2006, Postgraduate Medical Journal.

[17]  Hoangmai H Pham,et al.  Health care market trends and the evolution of hospitalist use and roles , 2005, Journal of General Internal Medicine.

[18]  Eric J Feuer,et al.  Projections of the cost of cancer care in the United States: 2010-2020. , 2011, Journal of the National Cancer Institute.

[19]  H. Tilly,et al.  Diffuse large B-cell non-Hodgkin's lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. , 2010, Annals of oncology : official journal of the European Society for Medical Oncology.

[20]  David Howard,et al.  Cancer treatment cost in the United States , 2010, Cancer.

[21]  J. Byrd,et al.  Non-Hodgkin's lymphomas, version 1.2013. , 2013, Journal of the National Comprehensive Cancer Network : JNCCN.

[22]  Hospitalist physician leadership skills: perspectives from participants of a leadership conference. , 2010, Journal of hospital medicine.

[23]  W. Ageno,et al.  Oral vitamin K effectively treats international normalised ratio (INR) values in excess of 10 , 2010, Thrombosis and Haemostasis.

[24]  Francisco Cervantes,et al.  The price of drugs for chronic myeloid leukemia (CML) is a reflection of the unsustainable prices of cancer drugs: from the perspective of a large group of CML experts. , 2013, Blood.

[25]  S. Ratzan,et al.  Health literacy: a policy challenge for advancing high-quality health care. , 2003, Health affairs.

[26]  P. Stein,et al.  Twenty-one-year trends in the use of inferior vena cava filters. , 2004, Archives of internal medicine.

[27]  M. Gent,et al.  Influence of thrombophilia on risk of recurrent venous thromboembolism while on warfarin: results from a randomized trial. , 2008, Blood.

[28]  Elaine Gray,et al.  Clinical guidelines for testing for heritable thrombophilia , 2010, British journal of haematology.

[29]  A. Ramsay.  Best Practice in Lymphoma Diagnosis and Reporting British Committee for Standards in Haematology , 2010 .

[30]  W. Whitcomb,et al.  The role of hospitalists in medical education. , 1999, The American journal of medicine.

[31]  J. Byrd,et al.  Non-Hodgkin's lymphomas, version 1.2013. , 2013, The Journal of the National Comprehensive Cancer Network.

[32]  Michael K Gould,et al.  Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. , 2012, Chest.

[33]  G. Stansby,et al.  Management of venous thromboembolic diseases and the role of thrombophilia testing: summary of NICE guidance , 2012, BMJ : British Medical Journal.

[34]  C. Wise,et al.  The effects of a low-cost intervention program on hospital costs , 1992, Journal of General Internal Medicine.

[35]  A. Norman,et al.  The Role of Surveillance CT Scans in Patients with Diffuse Large B-cell Non-Hodgkin's Lymphoma , 2003, Leukemia & lymphoma.

[36]  J. Kline,et al.  Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension: A Scientific Statement From the American Heart Association , 2011, Circulation.

[37]  D. Hunter,et al.  Qualitative Research: Consensus methods for medical and health services research , 1995 .

[38]  A. Zelenetz,et al.  Surveillance imaging during remission identifies a group of patients with more favorable aggressive NHL at time of relapse: a retrospective analysis of a uniformly-treated patient population. , 2006, Annals of oncology : official journal of the European Society for Medical Oncology.

[39]  J. Kaufman,et al.  Systematic review of the use of retrievable inferior vena cava filters. , 2011, Journal of vascular and interventional radiology : JVIR.