The ASH Choosing Wisely® campaign: five hematologic tests and treatments to question
The ASH Choosing Wisely® campaign: five hematologic tests and treatments to question
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DOI：
10.1182/blood-2013-07-518423
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发表时间：
2013-12-05
期刊：
影响因子：
20.3
通讯作者：
Crowther, Mark A.
中科院分区：
文献类型：
--
作者：
Hicks, Lisa K.;Bering, Harriet;Crowther, Mark A.
Choose Wisely (R) 是一项医疗管理和质量改进计划，由美国内科医学委员会基金会与美国领先的医学会合作领导。 ASH 是“明智选择 (R)”项目的积极参与者。 ASH 使用迭代过程和基于证据的方法，确定了 5 种测试和治疗方法，这些测试和治疗方法在某些情况下没有得到证据的充分支持，并且在某些情况下涉及不良事件和财务成本的风险，而获益的可能性很低。 ASH Choice Wisely (R) 建议的重点是避免自由红细胞输血，避免在存在短暂性主要血栓形成危险因素的情况下对成人进行血栓形成倾向测试，除非在特定情况下避免使用下腔静脉过滤器，避免在维生素 K 拮抗剂的非紧急逆转中使用血浆或凝血酶原复合物浓缩物，以及限制非霍奇金淋巴瘤治疗后的常规计算机断层扫描监测。我们建议临床医生在进行已确定的测试和治疗之前仔细考虑其预期益处。 （血。2013；122（24）：3879-3883）
Choosing Wisely (R) is a medical stewardship and quality improvement initiative led by the American Board of Internal Medicine Foundation in collaboration with leading medical societies in the United States. The ASH is an active participant in the Choosing Wisely (R) project. Using an iterative process and an evidence-based method, ASH has identified 5 tests and treatments that in some circumstances are not well supported by evidence and which in certain cases involve a risk of adverse events and financial costs with low likelihood of benefit. The ASH Choosing Wisely (R) recommendations focus on avoiding liberal RBC transfusion, avoiding thrombophilia testing in adults in the setting of transient major thrombosis risk factors, avoiding inferior vena cava filter usage except in specified circumstances, avoiding the use of plasma or prothrombin complex concentrate in the nonemergent reversal of vitamin K antagonists, and limiting routine computed tomography surveillance after curative-intent treatment of non-Hodgkin lymphoma. We recommend that clinicians carefully consider anticipated benefits of the identified tests and treatments before performing them. (Blood. 2013; 122(24):3879-3883)