Letter
Medicine, General & Internal
Kirstin W. Scott, A. Mark Fendrick, Catherine A. Sarkisian
Summary: The Choosing Wisely campaign aimed to reduce the use of low-value care, but has not been fully successful. The campaign utilized conversation between patients and clinicians to address this issue, which was a groundbreaking approach and widely implemented.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Surgery
Anees B. Chagpar, Elisabeth Dupont, Akiko Chiba, Edward A. Levine, Jennifer S. Gass, Sharon Lum, Eric Brown, Andrew Fenton, Naveenraj L. Solomon, David W. Ollila, Mary Murray, Kristalyn Gallagher, Marissa Howard-McNatt, Melissa Lazar, Carlos Garcia-Cantu, Laura Walters, Sonali Pandya, Amanda Mendiola, Jukes P. Namm
Summary: This study found that the use of preoperative MRI is influenced by patient age, tumor histology, and individual surgeons. Younger patients with invasive lobular tumors are more likely to have a preoperative MRI. Female surgeons and those in community practice are more likely to order preoperative MRI. The study also found that the use of preoperative MRI declined over time, particularly among female surgeons.
AMERICAN JOURNAL OF SURGERY
(2022)
Article
Oncology
J. C. Chen, Yaming Li, James L. Fisher, Oindrila Bhattacharyya, Allan Tsung, Samilia Obeng-Gyasi
Summary: This study found that there is an association between neighborhood socioeconomic status (nSES) and receipt of low-value breast cancer procedures. Patients residing in low nSES neighborhoods are more likely to undergo low-value axillary lymph node dissection (ALND), but less likely to receive low-value sentinel lymph node biopsies (SLNB) or contralateral prophylactic mastectomies (CPM) compared to patients in high nSES neighborhoods.
JOURNAL OF SURGICAL ONCOLOGY
(2022)
Article
Critical Care Medicine
A. D. Rogers, A. Amaral, R. Cartotto, A. El Khatib, R. Fowler, S. Logsetty, C. Malic, S. Mason, D. Nickerson, A. Papp, J. Rasmussen, D. Wallace
Summary: The Choosing Wisely Campaign is an international movement aimed at reducing unnecessary or potentially harmful investigations and procedures. This study focuses on providing Choosing Wisely recommendations for burn care, with the goal of decreasing medical costs and adverse effects while maintaining evidence-based care standards.
Article
Critical Care Medicine
Jerry J. Zimmerman, Lori A. Harmon, Pamela L. Smithburger, Darlene Chaykosky, Alan C. Heffner, Marilyn Hravnak, Jason M. Kane, Joshua B. Kayser, Meghan B. Lane-Fall, Renee Matos, Riza Mauricio, David J. Murphy, Michael Nurok, Anita J. Reddy, Eric Ringle, Edward G. Seferian, Norma M. Smalls-Mantey, Kathleen B. To, Lewis J. Kaplan
Summary: This study formulated new Choosing Wisely recommendations for critical care, focusing on avoiding waste and promoting the value of critical care practices. Through literature review and survey assessments, five top scoring recommendations were identified to enhance critical care practices within the Society of Critical Care Medicine.
CRITICAL CARE MEDICINE
(2021)
Article
Surgery
Sara Grossi, Julie Le, Ava Armani
Summary: Axillary surgery for breast cancer has evolved, with sentinel lymph node biopsy replacing axillary lymph node dissection. The information obtained from axillary staging is important for prognosis and treatment recommendations. However, recent studies suggest that select low-risk patients may not need sentinel lymph node biopsy, leading to improved adherence to guidelines and prevention of overtreatment in older people.
Review
Oncology
Hely Shah, Julian Surujballi, Arif Ali Awan, Brian Hutton, Angel Arnaout, Risa Shorr, Lisa Vandermeer, Mashari Jemaan Alzahrani, Mark Clemons
Summary: Choosing Wisely (CW)(R) was created by the American Board of Internal Medicine (ABIM) to promote patient-physician conversations about unnecessary medical interventions, and other countries have developed their own CW (R) campaigns. A review of CW (R) recommendations regarding breast cancer care practices showed a high rate of consensus between different organizations in reducing overutilization of investigations and treatments.
BREAST CANCER RESEARCH AND TREATMENT
(2021)
Article
Nursing
Eva W. W. Verkerk, Getty Huisman-de Waal, Lydia C. C. Overtoom, Gert P. P. Westert, Hester Vermeulen, Rudolf B. B. Kool, Simone A. A. van Dulmen
Summary: This mixed methods study evaluated the adherence of nurses and physicians in the Netherlands to the Choosing Wisely recommendations for acute wound care, as well as the barriers and facilitators to improve adherence. The survey results showed that although most healthcare providers were aware of the recommendations, not all adhered to them. Increasing awareness alone is not enough; a tailored approach that addresses barriers and improves knowledge and the work environment is necessary for successful implementation.
INTERNATIONAL JOURNAL OF NURSING PRACTICE
(2023)
Review
Medicine, General & Internal
Ludovico Furlan, Pietro Di Francesco, Giorgio Costantino, Nicola Montano
Summary: In recent years, the Choosing Wisely and Less is More campaigns have been gaining attention in the medical scientific community. These campaigns aim to improve patient-centered care by encouraging confrontation between patients and physicians. Physicians should consider uncertainty and evaluate evidence, patient preferences, and individual patient characteristics when making treatment decisions. They should also carefully assess potential harms and consequences, as well as patients' needs and preferences. Adopting this cognitive process can lead to a shift in patient management towards finding the best management strategy for each individual.
JOURNAL OF INTERNAL MEDICINE
(2022)
Article
Oncology
Francesca Tamburelli, Riccardo Ponzone
Summary: Breast-conserving surgery is a significant advancement in surgical oncology, but mastectomy is still performed in certain circumstances. Various factors, including patient and surgeon motivations, influence the decision-making process between breast preservation and mastectomy. The re-excision rate has been proposed as a quality metric for assessing and comparing performance, and accurate case-mix adjustment is crucial when using it as a performance indicator.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Review
Health Care Sciences & Services
Betsy Q. Cliff, Anton L. Avancena, Richard A. Hirth, Shoou-Yih Daniel Lee
Summary: Interventions based on Choosing Wisely recommendations are effective in reducing low-value medical services. Targeting clinicians and using multiple components for interventions are more likely to achieve intended results. There is a lack of research on consumer-based interventions, highlighting the need for further studies in this area.
Review
Health Care Sciences & Services
Betsy Q. Cliff, Anton L. V. Avancena, Richard A. Hirth, Shoou-Yih Daniel Lee
Summary: Dissemination of Choosing Wisely guidelines alone may not reduce the use of low-value health services significantly. Interventions targeting clinicians with multiple components are currently the most effective. More high-quality studies with active controls are needed to further evaluate intervention effectiveness.
Article
Health Care Sciences & Services
Gillian Parker, Monika Kastner, Karen Born, Nida Shahid, Whitney Berta
Summary: This study aims to elucidate the various factors that influence the processes and outcomes of de-implementation initiatives intended to address the recommendations of national Choosing Wisely campaigns. The findings highlight the importance of factors impacting the maintenance of low-value care (LVC) as well as the success of de-implementation interventions to reduce LVC. The study also emphasizes the significance of unintentional factors, the impact of harm and resources, and challenges the overstated impact of patients in de-implementation literature.
BMC HEALTH SERVICES RESEARCH
(2022)
Article
Surgery
Ton Wang, Brooke C. Bredbeck, Brandy Sinco, Sarah Shubeck, Alison S. Baskin, Ted Skolarus, Lesly A. Dossett
Summary: The study identified variation and determinants of persistent use of low-value breast cancer surgical care, with significant interfacility variation and facility-level characteristics associated with differential deimplementation and performance, suggesting the need for targeted interventions.
Article
Oncology
Ton Wang, Christina Weed, Joshua Tseng, Alice Chung, Marissa K. Boyle, Farin Amersi, Jaswinder Jutla, Amin Mirhadi, Armando E. Giuliano
Summary: This study evaluated the de-implementation of radiotherapy and sentinel lymph node biopsy (SLNB) in older women with low-risk invasive breast cancer (IBC) after the COVID-19 pandemic. The results showed a significant decrease in radiotherapy utilization and SLNB rates among low-risk patients. Age, tumor size, grade, and nodal status were significantly associated with the receipt of radiotherapy and SLNB in low-risk IBC.
ANNALS OF SURGICAL ONCOLOGY
(2023)
