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‘Choosing Wisely’: a growing international campaign
  1. Wendy Levinson1,
  2. Marjon Kallewaard2,
  3. R Sacha Bhatia1,
  4. Daniel Wolfson3,
  5. Sam Shortt4,
  6. Eve A Kerr5
  7. On behalf of the Choosing Wisely International Working Group
  1. 1Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  2. 2Dutch Association of Medical Specialists, Utrecht, The Netherlands
  3. 3ABIM Foundation, Philadelphia, USA
  4. 4Canadian Medical Association, Ottawa, Canada
  5. 5VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, and Department of Internal Medicine and Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, USA
  1. Correspondence to Dr Wendy Levinson, Professor of Medicine, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada M5B 1X1; wendy.levinson{at}


Much attention has been paid to the inappropriate underuse of tests and treatments but until recently little attention has focused on the overuse that does not add value for patients and may even cause harm. Choosing Wisely is a campaign to engage physicians and patients in conversations about unnecessary tests, treatments and procedures. The campaign began in the United States in 2012, in Canada in 2014 and now many countries around the world are adapting the campaign and implementing it. This article describes the present status of Choosing Wisely programs in 12 countries. It articulates key elements, a set of five principles, and describes the challenges countries face in the early phases of Choosing Wisely. These countries plan to continue collaboration including developing metrics to measure overuse.

  • Healthcare quality improvement
  • Patient safety
  • Quality improvement

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