ASTRO Choosing Wisely

[142348]

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What do people think about ASTRO's Choosing Wisely point?

#1-4 seem like pretty common sense to me though I was suprised they didn't mention life expectency as part of the AS discussion. I think hypofx for breast is here to stay.

#5 was pretty suprising- I guess i see IMRT for breast cancer as a reasonable choice. With the publication of the Cambridge IMRT trial I feel more comfortable as that was 3D wedges v. FIF IMRT compared with the old trials which used 2D v. FIF. I guess the issue is if you can do FIF why do and bill IMRT? I don't agree that FIF is 3DCRT but the powers that be say it is so we are stuck there.

 

[medgator]

For reference

http://www.choosingwisely.org/doctor-patient-lists/american-society-for-radiation-oncology/

 

[texan2009]

Starting the recommendations with "don't initiate" or "don't routinely" gives physicians some wiggle room to ignore these imo.

 

[medgator]

Interesting to read the lists from other specialty societies as they relate to cancer

http://www.choosingwisely.org/doctor-patient-lists/american-college-of-surgeons/

http://www.choosingwisely.org/doctor-patient-lists/the-society-of-thoracic-surgeons/

http://www.choosingwisely.org/doctor-patient-lists/american-urological-association/

http://www.choosingwisely.org/doctor-patient-lists/commission-on-cancer/