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Table 1 Overview of Sources of Low Value Care Recommendations

From: Moving low value care lists into action: prioritizing candidate health technologies for reassessment using administrative data

National Institute for Health and Care Excellence (NICE) Do Not Do Recommendations

As part of their technology assessment infrastructure in the United Kingdom, NICE has evaluated the clinical- and cost-effectiveness of existing technologies concomitant to the assessment of new technologies in a process known as multiple technology assessment (MTA). MTAs involve evidence syntheses of clinical- and cost-effectiveness of a given technology and its alternatives, as well as guidance for policy or practice implementation. Over time, a number of low values technologies currently in use in the National Health Service have been identified. Referred to as the “Do Not Do” recommendations, NICE has developed the most extensive collection of existing technologies of uncertain effect or absence of evidence.

Low value technologies in the Australian Medical Benefits Schedule (MBS)

Elshaug et al. [12] identified over 150 candidate technologies for reassessment in the Australian MBS. The Australian government funded the study to implement an evidence-based process to manage the MBS and ensure continued listing of clinical- and cost-effective technologies. A multiplatform approach was used to survey the peer-reviewed literature, conduct a targeted database search of reassessment recommendations in other jurisdictions, and obtain expert input through sampling of local stakeholders.

The International Choosing Wisely Campaign

Choosing Wisely is one of the most widely implemented low value list-making initiatives. Founded in the United States by the American Board of Internal Medicine, and now in over 12 countries, the Choosing Wisely campaign engaged medical societies to develop lists of low value tests and procedures across various medical specializations. Processes to develop the lists have varied from expert consensus exercises to systematic and non-systematic reviews of the literature. The campaign is intended to facilitate conversations between physicians and patients about unnecessary tests and treatments and make smart and effective choices to ensure high-quality care. Specifically in Canada, there are over 30 lists and over 200 low value tests and procedures.