ASH Releases Second List for Choosing Wisely Campaign

The American Society of Hematology (ASH) has announced five additional commonly used tests, treatments, and procedures in hematology that physicians and patients should question in certain circumstances. The additional items join an initial list of five practices to question that the Society released this past year as part of the Choosing Wisely^® campaign, an initiative of the American Board of Internal Medicine Foundation.

These new practices to question are also highlighted in a recent issue of Blood.¹

Recommendations

ASH’s new Choosing Wisely recommendations include the following five practices:

• Don’t treat with an anticoagulant agent for more than 3 months in a patient with a first venous thromboembolism that has occurred in the setting of a major transient risk factor.
• Don’t routinely transfuse patients with sickle cell disease for chronic anemia or uncomplicated pain crisis without an appropriate clinical indication.
• Don’t perform baseline or routine surveillance computed tomography scans in patients with asymptomatic, early-stage chronic lymphocytic leukemia.
• Don’t test or treat for suspected heparin-induced thrombocytopenia in patients with a low pretest probability of heparin-induced thrombocytopenia.
• Don’t treat patients with immune thrombocytopenic purpura in the absence of bleeding or a very low platelet count.

Evidence-Based Methodology

The second ASH Choosing Wisely list was developed using a rigorous evidence-based methodology that incorporated suggestions from ASH members and prioritized avoiding harm to patients above all other considerations. The goal of the list is to start conversations both within the hematology community and among physicians and their patients about how everyone can maximize the quality of hematologic care.

“Unnecessary treatments or tests not only add waste to the health-care system, but in some cases they also expose our patients to a risk of harm,” said Lisa Hicks, MD, of St. Michael’s Hospital and the University of Toronto and Chair of the ASH Choosing Wisely Task Force.

“ASH developed its second Choosing Wisely list to help hematologists manage the utilization and delivery of patient-care resources, and the Society encourages hematologists to consider these recommendations in all facets of their work, including patient care, teaching, innovation, and
research,” she added. ■

Reference

1. Hicks LK, Bering H, Carson KR, et al: The second ASH choosing wisely campaign: Five hematologic tests and treatments to question. Blood. December 3, 2014 (early release online).