Healthcare quality and “Choosing Wisely” initiative

Abstract

From a campaign driven by the American Board of Internal Medicine (ABIM) Foundation, the Choosing Wisely Initiative began in 2011 when several US societies from different medical specialties presented lists of procedures that are used excessively and therefore inappropriate. In this article we sought to highlight the relationship between healthcare quality, unjustified variation in supply of low-value procedures and the initiatives to reduce the overuse of those procedures. In addition to appropriate methodology, one should take account of criteria to evaluate whether or not the use of given procedures is recommended. The most important criteria are: the transparency and participation of a broader group of professionals, including different specialties; selection of procedures whose utility with regard to improving health is scientifically questionable and its costs to health services are excessive relative to benefits; the possibilty to measure and evaluate these procedures; the absence of any conflict of interest or corporatism.