title: Five hematologic tests and treatments to question.
abstract: Choosing Wisely® is a medical stewardship initiative led by the American Board of Internal Medicine Foundation in collaboration with professional medical societies in the United States. The American Society of Hematology (ASH) released its first Choosing Wisely® list in 2013. Using the same evidence-based methodology as in 2013, ASH has identified 5 additional tests and treatments that should be questioned by clinicians and patients under specific, indicated circumstances. The ASH 2014 Choosing Wisely® recommendations include: (1) do not anticoagulate for more than 3 months in patients experiencing a first venous thromboembolic event in the setting of major, transient risk factors for venous thromboembolism; (2) do not routinely transfuse for chronic anemia or uncomplicated pain crises in patients with sickle cell disease; (3) do not perform baseline or surveillance computed tomography scans in patients with asymptomatic, early-stage chronic lymphocytic leukemia; (4) do not test or treat for heparin-induced thrombocytopenia if the clinical pretest probability of heparin-induced thrombocytopenia is low; and (5) do not treat patients with immune thrombocytopenia unless they are bleeding or have very low platelet counts.
authors.affiliation: University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada;
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Hicks
authors.affiliation: Harvard Vanguard Medical Associates, Beverly, MA;
authors.forename: Harriet
authors.initials: H
authors.lastname: Bering
authors.affiliation: Washington University, St. Louis, MO;
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Carson
authors.affiliation: AE Health Consulting, Dunnville, Ontario, Canada;
authors.forename: Adam E
authors.initials: AE
authors.lastname: Haynes
authors.affiliation: Medical Specialists of Taunton, Taunton, MA;
authors.forename: Judith
authors.initials: J
authors.lastname: Kleinerman
authors.affiliation: University of Toronto, University Health Network, Toronto, Ontario, Canada;
authors.forename: Vishal
authors.initials: V
authors.lastname: Kukreti
authors.affiliation: University of North Carolina, Chapel Hill, NC;
authors.forename: Alice
authors.initials: A
authors.lastname: Ma
authors.affiliation: All Children's Hospital Johns Hopkins Medicine, St. Petersburg, FL;
authors.forename: Brigitta U
authors.initials: BU
authors.lastname: Mueller
authors.affiliation: Nationwide Children's Hospital, Columbus, OH;
authors.forename: Sarah H
authors.initials: SH
authors.lastname: O'Brien
authors.affiliation: Medical College of Wisconsin/Children's Hospital of Wisconsin, Milwaukee, WI;
authors.forename: Julie A
authors.initials: JA
authors.lastname: Panepinto
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI;
authors.forename: Marcelo C
authors.initials: MC
authors.lastname: Pasquini
authors.affiliation: University of Florida, Gainesville, FL; and.
authors.forename: Anita
authors.initials: A
authors.lastname: Rajasekhar
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Ravi
authors.initials: R
authors.lastname: Sarode
authors.affiliation: University of North Carolina, Chapel Hill, NC;
authors.forename: William A
authors.initials: WA
authors.lastname: Wood
mesh_terms: D006287:Health Planning Guidelines; D006403:Hematologic Tests / Q000379:methods*; D006801:Humans; D017410:Practice Guidelines as Topic