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Key Features Underlying Low-Value Care Recommendations

In an article published in the American Journal of Medical Quality, VSSL members Leah Marcotte and Joshua Liao analyze the features underlying popular low-value care recommendations from the Choosing Wisely campaign.

As Drs. Marcotte and Liao write:


"One potential reason that low-value care remains persistent is variation in recommendations created to deter it. A better understanding of key features, and how they differ across a range of recommendations, can offer insight about improvement opportunities. To address this knowledge gap, the authors described 3 features using a broad set of consensus Choosing Wisely recommendations: underlying rationales (ie, avoidance of waste and/or harm), types of services targeted, and types of supportive evidence used. The minority of recommendations were accompanied by rationales invoking waste (36%), harm (17%), and both (40%); 7% of recommendations were accompanied by no rationales. The most commonly targeted service type was diagnostic imaging (31%), while the least commonly targeted service type was clinical referrals/consults (1%). Most recommendations (50%) utilized guidelines as sources.

According to the study team, these findings highlight several opportunities to modify low-value care recommendations in order to ultimately strengthen efforts to reduce low-value care. Read the full article here.


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