Appraising the Evidence Supporting Choosing Wisely® Recommendations

被引:13
作者
Admon, Andrew J. [1 ,2 ]
Gupta, Ashwin [1 ,3 ]
Williams, Margaret [4 ]
Valley, Thomas S. [1 ,2 ]
Sjoding, Michael W. [1 ,2 ]
Wiener, Renda Soylemez [5 ,6 ]
Cooke, Colin R. [1 ,2 ,7 ]
机构
[1] Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Div Pulm & Crit Care Med, Ann Arbor, MI 48109 USA
[3] Vet Affairs Ann Arbor Healthcare Syst, Ann Arbor, MI USA
[4] Ohio State Univ, Dept Internal Med, Wexner Med Ctr, Columbus, OH 43210 USA
[5] Edith Nourse Rogers Mem Vet Affairs Hosp, Ctr Healthcare Org & Implementat Res, Bedford, MA USA
[6] Boston Univ, Sch Med, Pulm Ctr, Boston, MA 02118 USA
[7] Univ Michigan, Ctr Healthcare Outcomes & Policy, Inst Healthcare Policy & Innovat, Ann Arbor, MI 48109 USA
基金
美国医疗保健研究与质量局;
关键词
CLINICAL-PRACTICE GUIDELINES; MEDICINE; 5; OPPORTUNITIES; HEALTH-CARE VALUE; SCIENTIFIC EVIDENCE; PHYSICIANS; QUALITY;
D O I
10.12788/jhm.2964
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Despite the growing enthusiasm surrounding the Choosing Wisely (R) campaign, little is known regarding the evidence underlying these recommendations. We extracted references for all 320 recommendations published through August, 2014, including the 10 adult and pediatric recommendations published by the Society for Hospital Medicine. We then categorized each item by evidence strength, and then assessed a sample of referenced clinical practice guidelines (CPGs) using the validated Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Among all recommendations, 70.3% cited CPGs, whereas 22.2% cited primary research as their highest level of evidence. Moreover, 7.8% cited case series, review articles, editorials, or lower quality data as their highest level of evidence. Hospital medicine recommendations were more likely to cite CPGs (90%) as their highest level of evidence. Among the sampled CPGs, the median overall score obtained using AGREE II was 54.2% (interquartile range [IQR] 33.3%-70.8%), whereas among hospital medicine-referenced CPGs, the median overall score was 58.3% (IQR 50.0%-83.3%). These findings suggest that Choosing Wisely (R) recommendations vary in terms of evidence strength. (C) 2018 Society of Hospital Medicine
引用
收藏
页码:688 / 691
页数:4
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