title: Choosing Wisely: assessment of current US top five list recommendations' trustworthiness using a pragmatic approach.
abstract: Identification of sufficiently trustworthy top 5 list recommendations from the US Choosing Wisely campaign.
  
  
  
  Not applicable.
  
  
  
  All top 5 list recommendations available from the American Board of Internal Medicine Foundation website.
  
  
  
  Compilation of US top 5 lists and search for current German highly trustworthy (S3) guidelines. Extraction of guideline recommendations, including grade of recommendation (GoR), for suggestions comparable to top 5 list recommendations. For recommendations without guideline equivalents, the methodological quality of the top 5 list development process was assessed using criteria similar to that used to judge guidelines, and relevant meta-literature was identified in cited references. Judgement of sufficient trustworthiness of top 5 list recommendations was based either on an 'A' GoR of guideline equivalents or on high methodological quality and citation of relevant meta-literature.
  
  
  
  412 top 5 list recommendations were identified. For 75 (18%), equivalents were found in current German S3 guidelines. 44 of these recommendations were associated with an 'A' GoR, or a strong recommendation based on strong evidence, and 26 had a 'B' or a 'C' GoR. No GoR was provided for 5 recommendations. 337 recommendations had no equivalent in the German S3 guidelines. The methodological quality of the development process was high and relevant meta-literature was cited for 87 top 5 list recommendations. For a further 36, either the methodological quality was high without any meta-literature citations or meta-literature citations existed but the methodological quality was lacking. For the remaining 214 recommendations, either the methodological quality was lacking and no literature was cited or the methodological quality was generally unsatisfactory.
  
  
  
  131 of current US top 5 list recommendations were found to be sufficiently trustworthy. For a substantial number of current US top 5 list recommendations, their trustworthiness remains unclear. Methodological requirements for developing top 5 lists are recommended.
authors.affiliation: Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria.|Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.
authors.forename: Karl
authors.initials: K
authors.lastname: Horvath
authors.affiliation: Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Semlitsch
authors.affiliation: Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria.|Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Jeitler
authors.affiliation: Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria.
authors.forename: Muna E
authors.initials: ME
authors.lastname: Abuzahra
authors.affiliation: Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria.
authors.forename: Nicole
authors.initials: N
authors.lastname: Posch
authors.affiliation: Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Domke
authors.affiliation: Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria.|Institute of General Practice, Goethe University Frankfurt am Main, Frankfurt, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Siebenhofer
mesh_terms: D003657:Decision Making; D019317:Evidence-Based Medicine; D005858:Germany; D006801:Humans; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D035502:Trust; D014481:United States; D019564:Unnecessary Procedures
keywords: Choosing Wisely; guidelines; top five lists; trustworthiness