Evidentiary Rationales for the Choosing Wisely Top 5 Lists

Aiming to reduce wasteful medical care, the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely initiative asks leading physician specialty societies to create a “Top 5” list of medical services that provide no overall benefit to patients in most situations.1,2 As of August 2013, 25 participating specialty societies had produced 1 or more Top 5 lists containing a total of 135 services. The goal of this study was to evaluate the role that evidence on benefits, risks, and costs plays in selecting a service for the Top 5 lists. As Choosing Wisely continues to grow, clarity on the evidentiary justifications for the lists will be crucial for the overall credibility of the campaign.