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VBCC - February 2015, Vol 6, No 1 - ASH 2014 Highlights
Alice Goodman

San Francisco, CA—At its 2014 meeting, the American Society of Hematology (ASH) released its second list of 5 common tests, treatments, and procedures to avoid in routine care.

This list adds to the first list of 5 practices to question, with the goal of initiating discussions between patients and physicians about the risks and benefits of certain procedures (www.hematology.org/choosingwisely).

The new Choosing Wisely recommendations are:

  • Don’t treat with an anticoagulant for more than 3 months in a patient with a first venous thromboembolism occurring 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 (HIT) in patients with a low pretest probability of HIT
  • Don’t treat patients with immune thrombocytopenic purpura in the absence of bleeding or a very low platelet count.
“Unnecessary treatments or tests not only add waste to the healthcare system, but in some cases they also expose our patients to a risk of harm,” said ASH Choosing Wisely Task Force Chair Lisa Hicks, MD, MSc, of St Michael’s Hospital and the University of Toronto, Ontario, Canada.

“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 said.

The guiding principle for the practices included in Choosing Wisely is to do no harm. Since the launch of the campaign in 2012, more than 100 national and state medical specialty societies, regional organizations, and consumer partners have joined this initiative.

Consumer Reports has joined the effort, spreading the word to patients all over the country to stimulate important discussions between physicians and patients about these and other practices.

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Last modified: February 19, 2015
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