Evaluating the Evidence for Choosing WiselyTM in Primary Care Using the Strength of Recommendation Taxonomy (SORT)

J Am Board Fam Med. 2016 Jul-Aug;29(4):512-5. doi: 10.3122/jabfm.2016.04.160003.

Abstract

Objective: The goal of this study was to evaluate the quality of evidence supporting primary care-relevant Choosing Wisely(TM) recommendations using the Strength of Recommendation Taxonomy (SORT).

Methods: All Choosing Wisely "top 5" lists published by American medical specialty societies through June 2014 were reviewed for relevance to primary care. Both authors independently applied SORT to generate an evidence letter grade for each of the included recommendations, relying on citations supplied by the nominating organizations.

Results: Of 310 recommendations, 224 were identified as being relevant to primary care. We rated 43 (19%) as SORT level of evidence A, 57 (25%) as B, and 124 (55%) as C.

Conclusion: We found that a majority of primary care-relevant Choosing Wisely recommendations are based on expert consensus or disease-oriented evidence. Further research is warranted to strengthen the evidence base supporting these recommendations in order to improve their acceptance and implementation into primary care.

Keywords: Consensus; Medical Societies; Medicine; Primary Health Care; Research; United States.

Publication types

  • Evaluation Study

MeSH terms

  • Choice Behavior
  • Consensus
  • Evidence-Based Medicine / economics
  • Evidence-Based Medicine / organization & administration*
  • Evidence-Based Medicine / standards
  • Fee-for-Service Plans
  • Health Care Costs*
  • Humans
  • Practice Guidelines as Topic
  • Primary Health Care / economics
  • Primary Health Care / organization & administration*
  • Primary Health Care / standards
  • Quality Improvement*
  • United States