De-implementing wisely: developing the evidence base to reduce low-value care

The value in the evidence: teaching residents to "choose wisely".

The Accreditation Council for Graduate Medical Education mandates that training physicians "incorporate considerations of cost awareness" into practice. However, medical education has traditionally avoided addressing costs, and most residency programs currently lack curricula to fulfill this requirement. With the recent widespread emphasis on unsustainable costs, inefficiencies, and waste in he...

Low value cardiac testing and Choosing Wisely.

To cite: Bhatia RS, Levinson W, Lee DS. BMJ Qual Saf Published Online First: [please include Day Month Year] doi:10.1136/ bmjqs-2014-003605 Just a few years prior to the famous Institute of Medicine (IOM) reports on safety and quality, an earlier IOM report classified all quality problems in healthcare as falling into three broad categories: underuse, overuse and misuse. Until recently, however...

How prevalent and costly are Choosing Wisely low-value services? Evidence from Medicare beneficiaries.

(1) Through the Choosing Wisely initiative, medical specialty societies identified non-indicated cardiac testing in low-risk patients and short-interval dual-energy X-ray absorptiometry (DXA) or bone density testing as low-value care. (2) Nationally, 13 percent of low-risk Medicare beneficiaries received non-indicated cardiac tests, and 10 percent of DXAs reimbursed by Medicare were administere...

The Evidence Base for Interventions to Reduce Malaria Mortality in Low and Middle-Income Countries Authors

Developing a framework to guide the de-adoption of low-value clinical practices in acute care medicine: a study protocol

BACKGROUND Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-v...