By Lynn Malec, MD, MSc, and Janice Staber, MD
“We are made wise not by the recollection of our past, but by the responsibility for our future.”
– George Bernard Shaw
The Choosing Wisely® campaign is an effort led by the American Board of Internal Medicine (ABIM) to support and engage physicians in improving stewardship of health care resources in the face of rising health care costs and, in some cases, reducing harm from unnecessary testing. Partnering with ABIM, ASH has developed evidence-based recommendations to guide hematologists in conversation with patients about the utility of specific testing and procedures. Topics of the ASH Choosing Wisely list include recommendations on the minimum number of red blood cell units necessary to relieve symptoms of anemia in stable noncardiac patients, avoiding testing for thrombophilia in adult patients with venous thromboembolism in the setting of a major transient risk factor such as surgery, trauma, or prolonged immobility, limitation of surveillance computed tomography scans in asymptomatic patients following curative-intent treatment for aggressive lymphoma, and more.
Previously the ASH Choosing Wisely lists focused on health care testing and treatment recommendations in the adult population. This year, ASH developed an exciting partnership with the American Society of Pediatric Hematology/Oncology (ASPHO) that consists of a community of more than 2,000 pediatric hematology/oncology professionals dedicated to improving the health and wellbeing of children, adolescents, and young adults with blood disorders and cancers. The ASH-ASPHO Choosing Wisely collaborative developed a new, pediatric- focused list of five tests to reduce overuse and to facilitate conversations between physicians and patients to optimize care decisions.
Presented during the Special-Interest Session on Monday, at 10:30 a.m., and co-chaired by Sarah O’Brien, MD, of Nationwide Children’s Hospital, and Mona Shah, MD, MBA, of Baylor College of Medicine Texas Children’s Hospital, the session will include a variety of recommendations from pediatric hematology. Participants will learn about choosing wisely when it comes to thrombophilia testing, preoperative hemostatic testing, and the transfusion of packed red cell and platelet products.
Dr. O’Brien wants participants to know that past Choosing Wisely sessions have been dynamic and fast-paced and she’s excited to have a pediatric-focused session at this year’s meeting. She believes the session will be of interest to both pediatric hematologists and oncologists, and to anyone interested in topics on patient safety and quality, regardless of patient age.
As Dr. O’Brien explains, “the true value of the Choosing Wisely sessions comes after each attendee returns home to their institution.” It is her “hope that each attendee will pick one or two of these recommendations that they particularly resonate with, and teach these best practices to their colleagues both within hematology and other relevant disciplines, and then work to make changes in the standard of care within their programs.” She goes on to note, “it is only through these boots-on-the-ground efforts that we can not only decrease unnecessary healthcare costs, but improve patient satisfaction, safety, and quality of care.”
Come open to learn, and expect to leave wiser.
Dr. Malec and Dr. Staber indicated no relevant conflicts of interest.