Patient-oriented evidence that matters (POEMs)™ suggest potential clinical topics for the Choosing Wisely™ campaign.
OBJECTIVE
We propose a method of identifying clinical topics for campaigns like Choosing Wisely.


METHODS
In the context of an ongoing continuing medication education program, we analyzed ratings on every patient-oriented evidence that matters (POEM) synopsis delivered in 2012 and 2013. Given the objective of the Choosing Wisely campaign, we focused this analysis on 1 specific item in the validated questionnaire used by physicians to rate POEMs. This questionnaire item is about "avoiding an unnecessary diagnostic test or treatment." For each POEM, we calculated frequencies and proportions for this item, then we identified the 20 POEMs that were most commonly associated with this item in 2012 and 2013. Finally, we determined whether the clinical topic of each of these POEMs was mentioned in the Choosing Wisely master list.


RESULTS
In 2012 and 2013 we received 506,809 completed questionnaires (or ratings) linked to 530 POEMs, for an average of 956 ratings per POEM. In 59% of these POEMs (n = 312), the most commonly expected type of health benefit was "avoiding an unnecessary diagnostic test or treatment." We then identified the top 20 POEMs most commonly associated with this item in each year by ranking all 312 POEMs from the top down. The clinical topic addressed by 29 of these 40 POEMs was not addressed in the Choosing Wisely master list. These topics fell into 3 categories: diagnostic tests, medical interventions, and surgical interventions.


CONCLUSIONS
"Big data" can identify clinical topics relevant to campaigns such as Choosing Wisely. This process represents a new way to inform the expert panel approach.
From the Herzl Family Practice Centre (RG, MS), the Department of Family Medicine (RG, PP), and the Faculty of Education (MS) McGill University, Montreal, Quebec (RG); The Lady Davis Institute, Montreal, Quebec, Canada (DT); The University of Virginia Health System, Charlottesville, VA (DCS); and Tufts University Family Medicine Residency, Cambridge Health Alliance, Malden, MA (AFS). roland.grad@mcgill.ca.
Roland
R
Grad
From the Herzl Family Practice Centre (RG, MS), the Department of Family Medicine (RG, PP), and the Faculty of Education (MS) McGill University, Montreal, Quebec (RG); The Lady Davis Institute, Montreal, Quebec, Canada (DT); The University of Virginia Health System, Charlottesville, VA (DCS); and Tufts University Family Medicine Residency, Cambridge Health Alliance, Malden, MA (AFS).
Pierre
P
Pluye
From the Herzl Family Practice Centre (RG, MS), the Department of Family Medicine (RG, PP), and the Faculty of Education (MS) McGill University, Montreal, Quebec (RG); The Lady Davis Institute, Montreal, Quebec, Canada (DT); The University of Virginia Health System, Charlottesville, VA (DCS); and Tufts University Family Medicine Residency, Cambridge Health Alliance, Malden, MA (AFS).
David
D
Tang
From the Herzl Family Practice Centre (RG, MS), the Department of Family Medicine (RG, PP), and the Faculty of Education (MS) McGill University, Montreal, Quebec (RG); The Lady Davis Institute, Montreal, Quebec, Canada (DT); The University of Virginia Health System, Charlottesville, VA (DCS); and Tufts University Family Medicine Residency, Cambridge Health Alliance, Malden, MA (AFS).
Michael
M
Shulha
From the Herzl Family Practice Centre (RG, MS), the Department of Family Medicine (RG, PP), and the Faculty of Education (MS) McGill University, Montreal, Quebec (RG); The Lady Davis Institute, Montreal, Quebec, Canada (DT); The University of Virginia Health System, Charlottesville, VA (DCS); and Tufts University Family Medicine Residency, Cambridge Health Alliance, Malden, MA (AFS).
David C
DC
Slawson
From the Herzl Family Practice Centre (RG, MS), the Department of Family Medicine (RG, PP), and the Faculty of Education (MS) McGill University, Montreal, Quebec (RG); The Lady Davis Institute, Montreal, Quebec, Canada (DT); The University of Virginia Health System, Charlottesville, VA (DCS); and Tufts University Family Medicine Residency, Cambridge Health Alliance, Malden, MA (AFS).
Allen F
AF
Shaughnessy
D035843:Biomedical Research / Q000592:standards*; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D010506:Periodicals as Topic; D011320:Primary Health Care / Q000592:standards*; D012955:Societies, Medical
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