ASH Members Choosing Wisely

The Choosing Wisely campaign was initiated by the American Board of Internal Medicine (ABIM) Foundation to encourage conversations between physicians, patients, and the community to promote medical care that is supported by evidence, avoids redundancy, reduces unnecessary testing, and minimizes harm. The ASH Choosing Wisely Task Force, led by Dr. Lisa Hicks, developed the ASH Choosing Wisely list using rigorous evidence-based methodology and the core values of harm, cost, strength of evidence, frequency, and control. The list was presented at the ASH annual meeting in December 2013 with simultaneous publication in Blood and the ASH Education Program. ASH has joined more than 60 medical professional societies by developing a list of 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 inpatients).
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 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. More information about ASH’s list, including a slide presentation that describes in detail how the list was created and the underlying evidence supporting the recommendations, can be found here.