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Measuring the effect of Choosing Wisely: an integrated framework to assess campaign impact on low-value care
  1. R Sacha Bhatia1,2,
  2. Wendy Levinson1,
  3. Samuel Shortt3,
  4. Ciara Pendrith2,
  5. Elana Fric-Shamji2,
  6. Marjon Kallewaard4,
  7. Wilco Peul5,
  8. Jeremy Veillard6,
  9. Adam Elshaug7,
  10. Ian Forde8,
  11. Eve A Kerr9
  1. 1Department of Medicine, University of Toronto, Toronto, Canada
  2. 2Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, Canada
  3. 3Health Policy Consultant, Ottawa, Canada
  4. 4Dutch Association of Medical Specialists, Utrecht, The Netherlands
  5. 5Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands
  6. 6Canadian Institute for Health Information, Toronto, Canada
  7. 7Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales, Australia
  8. 8OECD, London, UK
  9. 9VA 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 R Sacha Bhatia, 76 Grenville Street, 6th floor, Toronto, Ontario, Canada M5S 1B2, Sacha.bhatia{at}


The Choosing Wisely campaign began in the USA in 2012 to encourage physicians and patients to discuss inappropriate and potentially harmful tests, treatments and procedures. Since its inception, the campaign has grown substantially and has been adopted by 12 countries around the world. Of great interest to countries implementing the campaign, is the effectiveness of Choosing Wisely to reduce overutilisation. This article presents an integrated measurement framework that may be used to assess the impact of a Choosing Wisely campaign on physician and provider awareness and attitudes on low-value care, provider practice behaviour and overuse of low-value services.

  • Quality improvement
  • Patient-centred care
  • Quality measurement

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