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ASH Issues 5 New “Choosing Wisely” Recommendations for Hematologists

February 2016, Vol 6, No 2

The American Society of Hematology (ASH) released 5 new recommendations for hematology-related tests and procedures to avoid, based on recommendations from other medical societies that are often adopted into each organization’s Choosing Wisely program.

These 5 new recommendations have now been added to the 10 previous recommendations issued by ASH in the past 2 years. The goal of this initiative is to prompt conversations between patients and clinicians about the necessity of certain tests and procedures. These items were also presented during the recent 57th ASH Annual Meeting in Orlando, FL.

The 5 new ASH recommendations (available at www.hematology.org/ChoosingWisely), are:

  • Don’t order imaging for suspected pulmonary embolism without moderate or high pretest probability of this condition (American College of Radiology)
  • Don’t routinely order thrombophilia testing for patients undergoing a routine infertility evaluation (American Society for Reproductive Medicine)
  • Don’t perform repetitive complete blood count and chemistry testing for a person with stable clinical status and laboratory results (Society of Hospital Medicine/Adult Hospital Medicine)
  • Don’t transfuse red blood cells for iron deficiency without hemodynamic instability (American Association of Blood Banks)
  • Avoid using positron emission tomography (PET) or PET-computed tomography scanning as part of routine follow-up care to monitor cancer recurrence in asymptomatic patients who have finished their initial treatment to eliminate the cancer, unless high-level evidence shows that imaging will change outcomes (American Society of Clinical Oncology).

“The Choosing Wisely initiative is a high visibility campaign that has increased awareness of overutilization in medicine, and at ASH we believe there is a potential for even greater impact when societies share information and work together to accomplish the same goals,” said ASH’s Choosing Wisely Task Force Chair Lisa Hicks, MD, from St Michael’s Hospital and the University of Toronto.

The ASH Task Force reviewed 400 recommendations before selecting these 5 priorities directly relevant to hematologists. Avoiding harm and improving quality of care are top guiding principles for ASH in choosing the recommendations, suggested Dr Hicks.

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