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Updated: Apr 20, 2026

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Five hematologic tests and treatments to question.

Lisa K Hicks1, Harriet Bering2, Kenneth R Carson3

  • 1University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada;

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|December 5, 2014
PubMed
Summary
This summary is machine-generated.

The American Society of Hematology (ASH) updated its Choosing Wisely(®) recommendations, advising against certain tests and treatments for conditions like venous thromboembolism and sickle cell disease to improve patient care.

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Area of Science:

  • Hematology
  • Medical Stewardship
  • Evidence-Based Medicine

Background:

  • Choosing Wisely(®) is a national initiative promoting appropriate medical care.
  • The American Society of Hematology (ASH) previously released guidelines in 2013.
  • There is a need to refine clinical practices based on the latest evidence.

Purpose of the Study:

  • To present five new evidence-based recommendations from ASH for the Choosing Wisely(®) campaign.
  • To guide clinicians and patients in questioning specific tests and treatments.
  • To reduce unnecessary medical interventions and improve patient outcomes.

Main Methods:

  • Utilized the established evidence-based methodology from the 2013 ASH Choosing Wisely(®) list.
  • Reviewed current clinical evidence and expert consensus.
  • Focused on specific hematologic conditions and common interventions.

Main Results:

  • Recommendation 1: Limit anticoagulation to 3 months for first venous thromboembolic events with transient risk factors.
  • Recommendation 2: Avoid routine transfusions for chronic anemia or uncomplicated pain crises in sickle cell disease.
  • Recommendation 3: Do not perform baseline/surveillance CT scans for asymptomatic early-stage chronic lymphocytic leukemia.
  • Recommendation 4: Avoid testing/treating for heparin-induced thrombocytopenia with low pretest probability.
  • Recommendation 5: Treat immune thrombocytopenia only if bleeding or platelet count is very low.

Conclusions:

  • These ASH Choosing Wisely(®) recommendations aim to optimize patient care by reducing unnecessary interventions.
  • Clinicians and patients should engage in shared decision-making regarding these specific tests and treatments.
  • Adherence to these guidelines can lead to more appropriate and effective hematologic care.