Appraising the Evidence Supporting Choosing Wisely® Recommendations

Overview

Journal J Hosp Med

Publisher Wiley

Specialties General Medicine
Health Services

Date 2018 Apr 26

PMID 29694449

Citations 5

Authors

Andrew J Admon

Ashwin Gupta

Margaret Williams

Thomas S Valley

Michael W Sjoding

Renda Soylemez Wiener

Colin R Cooke

Affiliations

Soon will be listed here.

Abstract

Despite the growing enthusiasm surrounding the Choosing Wisely® campaign, little is known regarding the evidence underlying these recommendations. We extracted references for all 320 recommendations published through August, 2014, including the 10 adult and pediatric recommendations published by the Society for Hospital Medicine. We then categorized each item by evidence strength, and then assessed a sample of referenced clinical practice guidelines (CPGs) using the validated Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Among all recommendations, 70.3% cited CPGs, whereas 22.2% cited primary research as their highest level of evidence. Moreover, 7.8% cited case series, review articles, editorials, or lower quality data as their highest level of evidence. Hospital medicine recommendations were more likely to cite CPGs (90%) as their highest level of evidence. Among the sampled CPGs, the median overall score obtained using AGREE II was 54.2% (IQR 33.3%-70.8%), whereas among hospital medicine-referenced CPGs, the median overall score was 58.3% (IQR 50.0%-83.3%). These findings suggest that Choosing Wisely® recommendations vary in terms of evidence strength.

Citing Articles

Why we all need Choosing Wisely?.

Lang E, Nozewski J Intern Emerg Med. 2023; 18(6):1613-1616.

PMID: 37477819 DOI: 10.1007/s11739-023-03356-y.

Longitudinal Content Analysis of the Characteristics and Expected Impact of Low-Value Services Identified in US Choosing Wisely Recommendations.

Ganguli I, Thakore N, Rosenthal M, Korenstein D JAMA Intern Med. 2021; 182(2):127-133.

PMID: 34870673 PMC: 8649907. DOI: 10.1001/jamainternmed.2021.6911.

Low-Value Care and Clinician Engagement in a Large Medicare Shared Savings Program ACO: a Survey of Frontline Clinicians.

Markovitz A, Rozier M, Ryan A, Goold S, Ayanian J, Norton E J Gen Intern Med. 2019; 35(1):133-141.

PMID: 31705479 PMC: 6957659. DOI: 10.1007/s11606-019-05511-8.

Highlighting the need for de-implementation - Choosing Wisely recommendations based on clinical practice guidelines.

Sipila R, Makela M, Komulainen J BMC Health Serv Res. 2019; 19(1):638.

PMID: 31488146 PMC: 6729023. DOI: 10.1186/s12913-019-4460-z.

Low-value care in Australian public hospitals: prevalence and trends over time.

Badgery-Parker T, Pearson S, Chalmers K, Brett J, Scott I, Dunn S BMJ Qual Saf. 2018; 28(3):205-214.

PMID: 30082331 PMC: 6559783. DOI: 10.1136/bmjqs-2018-008338.

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