Choosing Wisely

At the American Society of Hematology (ASH) 57th Annual Meeting in December 2015, the ASH Choosing Wisely Task Force highlighted five relevant recommendations that were made by other organizations and are pertinent to the practice of hematology. The “Choosing Wisely” campaign was launched in 2012 by the American Board of Internal Medicine, and since then, other health-related organizations have created their own lists of medical procedures to avoid or not perform. ASH developed its own specialty-based recommendations in 2013 and added an additional five recommendations in 2014. This year, ASH is highlighting recommendations made by other organizations but are applicable to ASH members.

The five recommendations are: 1) Don't perform imaging studies for a suspected pulmonary embolism (PE) without moderate or high pretest probability of PE (from the American College of Radiology); 2) Don't routinely order thrombophilia testing on patients undergoing a routine infertility evaluation (from the American Society for Reproductive Medicine); 3) Don't perform repetitive complete blood count and chemistry testing when the patient is clinically stable and there has not been any change in laboratory test results (from the Society for Hospital Medicine — Adult Hospital Medicine); 4) Don't transfuse red blood cells for iron deficiency when there is no hemodynamic instability (from the American Association of Blood Banks); and 5) Avoid using PET or PET–CT scanning as part of routine follow-up care to monitor for a cancer recurrence in asymptomatic patients who have finished initial cancer treatment unless there is high-level evidence that such imaging will change the outcome of care (from the American Society of Clinical Oncology).