American Society of Hematology

The ASH Choosing Wisely List

Developed as part of Choosing Wisely®, an initiative of the ABIM Foundation, the ASH Choosing Wisely list provides evidence-based recommendations in an effort to prompt conversations between patients and physicians about the necessity and potential harm of certain practices. The list was developed after months of careful data analysis and review, as well as input from the Society's membership, using the most current evidence about management and treatment options. The list, which was also highlighted in a manuscript published in Blood in December 2013, identifies the following five tests, treatments, and procedures that hematologists and their patients should question:

  1. Do not transfuse more than the minimum number of red blood cell (RBC) units necessary to relieve symptoms of anemia or to return a patient to a safe hemoglobin range (7 to 8 g/dL in stable, non-cardiac, in-patients).
  2. Don't test for thrombophilia in adult patients with venous thromboembolism (VTE) occurring in the setting of major transient risk factors (surgery, trauma or prolonged immobility).
  3. Don't use inferior vena cava (IVC) filters routinely in patients with acute venous thromboembolism (VTE).
  4. Don't administer plasma or prothrombin complex concentrates for non-emergent reversal of vitamin K antagonists (i.e. outside of the setting of major bleeding, intracranial hemorrhage or anticipated emergent surgery).
  5. Limit surveillance computed tomography (CT) scans in asymptomatic patients following curative-intent treatment for aggressive lymphoma.

Choosing Wisely®is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources. Participating specialty societies are working with the ABIM Foundation and Consumer Reports to share the lists widely with their members and convene discussions about the physician's role in helping patients make wise choices. Learn more at www.ChoosingWisely.org.

Additional Presentation Materials

In support of the Choosing Wisely initiative, the ASH Choosing Wisely Task Force has produced an educational presentation to serve as a companion to the ASH Choosing Wisely list. The presentation describes in detail how the list was created and the underlying evidence supporting the recommendations. The presentation can be downloaded as a PowerPoint slide deck or a PDF document for printing. Members are encouraged to use the presentation and to share it among colleagues.

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