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Choosing Wisely

“Things Clinicians and Patients Should Question”

ABIM Foundation campaign launched in 2012 in which US medical specialty societies each published lists of common tests and treatments their own members overuse, to start conversations between clinicians and patients about what care is needed. Nine societies offered 45 examples at launch; more than 80 societies took part by 2023. Consumer Reports produced patient versions, and the model spread to Canada, Australia, the UK and other countries.

Years
2012–2023
Country
United States
Topic
Low value care
Asks people to
StopTalk to someone
Strategy
Coined termSimple instructionTrusted messenger
Channel
Clinical settingEventsPrintWebsite
Audience
AdultsClinicians
Physicians and other clinicians in the specialties that wrote lists; patients through Consumer Reports plain-language versions.

Evidence

ObservationalMixed

Anthem commercial claims, 7 early recommendations, through 2013 (Rosenberg 2015): imaging for headache fell from 14.9% to 13.4% and cardiac imaging in low-risk patients from 10.8% to 9.7%; NSAID use in at-risk patients and HPV testing in women under 30 rose; antibiotics for sinusitis, preoperative chest x-rays and low back pain imaging did not change. Authors concluded effects were marginal and further interventions were needed. Hong et al. (2017) found only a 4 percent decline in low-value back imaging associated with the campaign. A systematic review of 131 articles (Cliff 2021) found interventions built on the recommendations can reduce low-value services, but only 17% of studies had a control arm.

Sponsor (who paid)

  • ABIM Foundation Foundation, creator and convener
  • US national medical specialty societies NGO, list authors

Credits (who made it)

Executions (individual ads)

Related campaigns

Sources

  1. Choosing Wisely: An Initiative of the ABIM Foundation (mission and history) sponsor
  2. Choosing Wisely Initiative (ABIM Foundation) sponsor
  3. Rosenberg A, Agiro A, Gottlieb M et al. Early Trends Among Seven Recommendations From the Choosing Wisely Campaign. JAMA Intern Med 175(12):1913-20 evaluation · 2015 · DOI 10.1001/jamainternmed.2015.5441 · PMID 26457643
  4. Hong AS et al. Small Decline In Low-Value Back Imaging Associated With The 'Choosing Wisely' Campaign, 2012-14. Health Aff (Millwood) 2017 evaluation · 2017 · DOI 10.1377/hlthaff.2016.1263 · PMID 28373333
  5. Cliff BQ et al. The Impact of Choosing Wisely Interventions on Low-Value Medical Services: A Systematic Review. Milbank Q 2021 evaluation · 2021 · DOI 10.1111/1468-0009.12531 · PMID 34402553
  6. Colla CH, Mainor AJ. Choosing Wisely Campaign: Valuable For Providers Who Knew About It, But Awareness Remained Constant, 2014-17. Health Aff (Millwood) 2017 evaluation · 2017 · DOI 10.1377/hlthaff.2017.0945 · PMID 29137515
  7. Hategeka C et al. Effect of the Choosing Wisely Canada campaign on prescription of nonsteroidal anti-inflammatory drugs in people with hypertension, heart failure or chronic kidney disease (preprint). medRxiv 2024 reference · 2024 · DOI 10.1101/2024.10.25.24316159
  8. Muscat DM et al. Randomized Trial of the Choosing Wisely Consumer Questions and a Shared Decision-Making Video Intervention on Decision-Making Outcomes. Med Decis Making 2023 reference · 2023 · DOI 10.1177/0272989x231184461 · PMID 37403779
  9. Laba TL et al. The impact of the Choosing Wisely Canada campaign on the simultaneous use of angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers: interrupted time-series analysis. CMAJ Open 2022 reference · 2022 · DOI 10.9778/cmajo.20210185 · PMID 36735223
  10. Prochaska MT et al. Trends in Troponin-Only Testing for AMI in Academic Teaching Hospitals and the Impact of Choosing Wisely®. J Hosp Med 2017 evaluation · 2017 · DOI 10.12788/jhm.2846 · PMID 29236093
  11. Welk B et al. The Impact of the Choosing Wisely Campaign in Urology. Urology 2018 reference · 2018 · DOI 10.1016/j.urology.2018.03.005 · PMID 29572056
  12. Lange SM et al. Impact of choosing wisely on imaging in men with newly diagnosed prostate cancer. Urol Oncol 2023 evaluation · 2023 · DOI 10.1016/j.urolonc.2022.09.007 · PMID 36307366
  13. Using Behavioral Economics to Reduce Low-Value Care Among Older Adults: A Cluster Randomized Clinical Trial evaluation · 2024 · DOI 10.1001/jamainternmed.2023.7703 · PMID 38285565
  14. Choosing Wisely: Treating insomnia in older people (AGS / Consumer Reports) sponsor
  15. Why seniors should think twice about sleep meds news

Research notes

Clinician-facing campaign. Discovered 2026-10-22 (clinician-campaigns pass). Fetched 2026-10-22: choosingwisely.org mission page (began 2012 with nine societies representing 375,000 clinicians and 45 examples; 80+ societies 2012-2023; lists no longer maintained; ABIM Foundation now focuses on Building Trust) - endYear 2023 reflects that wind-down, not a formal end date. Consumer Reports credit: the mission page names it as a partner; role "pr" is approximate (it produced patient materials). Tagline is the lists' standard heading, not confirmed on a fetched page. YouTube executions are ABIM Foundation channel videos (about 6-12 years old; years not confirmed). Taxonomy gap: topic "low-value-care" is not in docs/taxonomy.md. Sources added 2026-10-22 (openalex-deep queue; DOIs checked on Crossref, Colla PMID via NCBI esummary): Colla & Mainor 2017 (physician awareness 21% to 25%, not significant, 2014-17); Hategeka 2024 preprint on Choosing Wisely Canada (interrupted time series: no overall change in NSAID prescribing, declines only in men and patients 65 or younger; not peer reviewed, Canadian branch). Evidence unchanged. Evaluation links reviewed 2026-10-22: Hategeka 2024 preprint evaluates Choosing Wisely Canada, not the US ABIM Foundation campaign; set to reference. Evaluation sources added 2026-10-22 (citation snowballing / helpline pass): Muscat 2023, Laba 2022, Prochaska 2017, Welk 2018, Lange 2023; evidence level and outcome unchanged. Muscat 2023 is an online randomized test of the consumer questions in a hypothetical scenario, so it does not raise the level. Evaluation links reviewed 2026-10-22: Muscat 2023 (Choosing Wisely Australia consumer questions), Laba 2022 and Welk 2018 (Choosing Wisely Canada) set to reference; they evaluate other countries' campaigns, not the US ABIM Foundation campaign. Evidence unchanged.

Record cases/choosing-wisely.json, updated 2026-10-23· Link to this campaign