With some studies suggesting that up to 30% of healthcare in the U.S. is unnecessary, Choosing Wisely was launched in 2011 as a joint effort between the American Board of Internal Medicine Foundation and eight other medical specialties to put the focus on unnecessary medical procedures.

Each of the nine societies agreed to contribute five procedures that were found to be contributing to wasteful spending, according to an opinion published April 4 in the Journal of the American Medical Association (JAMA, April 4, 2012, Vol. 307: 13, pp. E1-E2).

Participating for radiology was the American College of Radiology (ACR), which identified the following imaging procedures whose necessity should be discussed before they are ordered by referring physicians. The list includes:

• Imaging for uncomplicated headache, absent specific risk factors for structural disease or injury
• Imaging for suspected pulmonary embolism (PE) without moderate or high pretest probability of PE
• Preoperative chest x-rays without specific reasons due to patient history or physical exam
• CT to evaluate suspected appendicitis in children until ultrasound is considered an option
• Follow-up imaging for adnexal (reproductive tract) cysts 5 cm or less in diameter in reproductive-age women

The ACR recommended that providers review the list and incorporate the information into their decision-making, according to Dr. John Patti, chair of the ACR Board of Chancellors, in a statement.

Each society's complete list of five tests, treatments, or services that are commonly used in the specialty and for which use should be carefully evaluated can be found at the Choosing Wisely website, the ACR said.

The JAMA opinion piece noted that the nine medical societies together potentially reach 374,000 practicing physicians, and several additional societies are interested in joining Choosing Wisely.

Also participating in the project is Consumer Reports, which is creating and disseminating consumer-friendly versions of the lists of unnecessary procedures to help patients understand the recommendations. The ACR said it is working with Consumer Reports on the distribution of patient-friendly resources.