Top POEMs for Choosing Wisely: Another Tool to Help Physicians Practice Good Medicine


Am Fam Physician. 2016 Oct 1;94(7):539.

Related article: Top POEMs of 2015 Consistent with the Principles of the Choosing Wisely Campaign

Related editorial: Of Wise Choices, Evidence That Matters, and Leaving Old Friends Behind

Regular readers of American Family Physician (AFP) know of our support of the Choosing Wisely campaign, a program designed to help avoid wasteful or unnecessary medical tests, treatments, and procedures.1 More than 70 specialty societies participate in this campaign, contributing more than 400 clinical recommendations—most advising clinicians what not to do to reduce harm and improve health. We've featured several editorials about Choosing Wisely 24 and created a list of primary care–relevant recommendations and a searchable database on our website (https://www.aafp.org/afp/recommendations/search.htm). In many of our articles, we include a table of relevant Choosing Wisely recommendations (for an example, see https://www.aafp.org/afp/2016/0715/p97.html). If you haven't explored Choosing Wisely lately, I encourage you to give it a try.

Choosing Wisely is one of several major campaigns combatting overscreening, overdiagnosis, and overtreatment.5 In this issue of AFP, we feature our newest addition to this effort: a collection of POEMs consistent with the principles of Choosing Wisely.6 POEMs (patient-oriented evidence that matters) are studies that address interventions that improve outcomes that matter to a patient's health (e.g., morbidity, mortality, quality of life), as opposed to disease-oriented evidence, which is based on surrogate markers that may or may not affect a patient's well-being (e.g., blood tests, imaging studies, physiologic mechanisms). A similar collection of POEMs was published last year,7 and with this installment, we anticipate publishing an annual list in AFP. Unlike the actual Choosing Wisely recommendations, some of which are based on expert opinion,8 the top POEMs are all based on patient-oriented evidence showing improved clinical outcomes. In addition, these POEMs were systematically validated by physicians as helping to avoid unnecessary clinical interventions.

If you're looking for concise lists of tips to change clinical practice for the better, I encourage you to consult this list of top POEMs for Choosing Wisely, as well as those in the related annual collections: Top 20 Research Studies for Primary Care Physicians.9

editor's note: Although similar, the article “Top POEMs of 2015 Consistent with the Principles of the Choosing Wisely Campaign” differs somewhat from our annual list of Top 20 Research Studies for Primary Care Physicians.9 Both are based on POEMs: in the former case, they are systematically rated for helping to avoid unnecessary clinical interventions; in the latter case, they are systematically rated for relevance to family physicians. There is some overlap between these two lists, and we have published the POEMs in common in an online table that accompanies the article.6 Dr. Siwek is editor of AFP.

Address correspondence to Jay Siwek, MD, at siwekj@georgetown.edu. Reprints are not available from the author.

Author disclosure: No relevant financial affiliations.


show all references

1. Choosing Wisely. http://choosingwisely.org. Accessed July 29, 2016....

2. Siwek J. Choosing Wisely: top interventions to improve health and reduce harm, while lowering costs. Am Fam Physician. 2012;86(2):128–133.

3. Siwek J, Lin KW. Choosing Wisely: More good clinical recommendations to improve health care quality and reduce harm. Am Fam Physician. 2013;88(3):164–168.

4. Siwek J, Lin KW. More ways to improve health and reduce harm: Choosing Wisely phase 3. Am Fam Physician. 2014;89(5):329.

5. Siwek J. Getting medicine right: overcoming the problem of overscreening, overdiagnosis, and overtreatment. Am Fam Physician. 2015;91(1):18–20.

6. Grad R, Ebell MH. Top POEMs of 2015 consistent with the principles of the Choosing Wisely campaign. Am Fam Physician. 2016;94(7):566–570.

7. Grad R, Pluye P, Tang D, Shulha M, Slawson DC, Shaughnessy AF. Patient-oriented evidence that matters (POEMs) suggest potential clinical topics for the Choosing Wisely campaign. J Am Board Fam Med. 2015;28(2):184–189.

8. Lin KW, Yancey JR. Evaluating the evidence for Choosing Wisely in primary care using the strength of recommendation taxonomy (SORT). J Am Board Fam Med. 2016;29(4):512–515.

9. American Family Physician. Top POEMs (patient-oriented evidence that matters). https://www.aafp.org/journals/afp/authors/ebm-toolkit/resources/top-poems.html. Accessed July 29, 2016.



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