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ASCO Plans to Expand ‘Top 5’ List

Butcher, Lola

doi: 10.1097/01.COT.0000425911.14656.7b


The American Society of Clinical Oncology became one of the first nine medical societies to join the “Choosing Wisely” campaign last spring when it published its “Top 5” list of common, costly tests and procedures in oncology that are not supported by evidence (OT, 6/25/12). The purpose of the list— and the ABIM Foundation's Choosing Wisely campaign overall—is to encourage physicians and patients to question those activities before proceeding with them.

Members of ASCO's Cost of Cancer Care Task Force are so enthusiastic about the “Top 5” approach that they are planning to extend the list to include five additional tests and procedures. Task Force Chair Lowell E. Schnipper, MD, said ASCO will ask its members to suggest tests and procedures to be considered for the expanded list.

Following the system it used to develop the Top 5 list, the task force will identify five additional items and seek feedback from ASCO committees, state society leaders, and the executive committee of the board of directors before finalizing the selections.

The Top 5 list helps guide oncologists to meet the growing demand for better value—defined as the best outcome at the lowest cost—in cancer care. As new payment systems emerge, oncologists will be pressured to reduce chemotherapy that does more harm than good, images that are not associated with improved patient outcomes, and patient out-of-pocket expenses for unnecessary care.

“The Top 5 is all about holding back those things that have no value,” Schnipper said. “I think this is the vanguard of what is going to be a real change” in the way oncologists practice.

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