The choosing wisely campaign and its potential impact on diagnostic radiation burden.

Imaging utilization grew dramatically from the late 1990s through the mid2000s, in large part because of increased access to multidetector CT and its transformative impact on medical diagnosis. The past 5 to 10 years, however, have seen more tempered growth in imaging utilization, along with an acutely increased awareness of its associated radiation burden [1,2]. This increased scrutiny has resulted in several strategies to reduce the overall diagnostic radiation burden to the population [3,4], including exposure reduction through protocol optimization (eg, ACR dose registry efforts), exposure avoidance through conventional utilization management (eg, provider decision support software), and innovative public relations initiatives such as the ACR’s Image Gently and Image isely campaigns. Early this year, a consortium of 9 medical professional societies, led by the American Board of Internal Medicine Foundation, followed in the ACR’s footsteps and created Choosing Wisely, a campaign to ublicize a series of 9 “top 5” lists of ituations in which diagnostic tests re routinely overordered [5]. The ampaign was focused on “encourging physicians, patients and other ealth care stakeholders to think nd talk about medical tests and rocedures that may be unnecesary and in some instances can ause harm.” Yet despite its intenionally broad scope, 56% (25 of 5) of the top 5 list items involve edical imaging. Even when one exludes the recommendations of the maging professional societies (the CR and the American Society of