{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T11:28:04Z","timestamp":1793618884903,"version":"4.5.0"},"reference-count":20,"publisher":"Walter de Gruyter GmbH","issue":"12","funder":[{"DOI":"10.13039\/n\/a","name":"Funded by the Foundation for Pathobiochemistry and Molecular Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/n\/a","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,11,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2026-0358_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Launched in 2012, the Choosing Wisely initiative promotes evidence-based recommendations to reduce unnecessary tests and treatments. This study reviewed laboratory-related recommendations from five countries (USA, UK, Germany, Switzerland, and Austria) to assess their scientific validity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0358_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Choosing Wisely websites were searched for laboratory-related recommendations. After removing duplicates, 49 randomly selected unique recommendations remained for this study. They were categorized by specialty and assessed for evidence quality using the Oxford 2009 system based on the sources cited by the original authors. Guidelines were rated by the study types supporting the recommendation, while narrative reviews and expert opinions received a lower level of evidence due to their weaker methodology, even if higher-quality studies were cited. The highest possible level of evidence was assigned from the sources provided.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0358_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 49 Choosing Wisely recommendations 58\u202f% were based on high evidence (levels I\u2013II), 14\u202f% on moderate evidence (level III), 18\u202f% on low evidence (level IV-V) and 10\u202f% could not be classified. Hematology, transfusion\/coagulation medicine, and oncology had the most level I evidence (75\u202f%), while infectiology, pediatrics, and reproductive medicine relied more on level V sources (each 29\u202f%). Cross-country comparison showed notable differences in the recommendations for laboratory medicine, reflecting national priorities in healthcare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0358_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Some of Choosing Wisely\u2019s laboratory-related recommendations are based on a high level of evidence, while others lack strong empirical support. Regular updates with high-quality research, international collaboration, and greater transparency are needed to improve the evidence base and patient\u00a0care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2026-0358","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T13:56:06Z","timestamp":1784642166000},"page":"2713-2722","source":"Crossref","is-referenced-by-count":0,"title":["Choosing Wisely\u00a0\u2013\u00a0avoiding medical overuse: evidence assessment of recommendations on laboratory parameters"],"prefix":"10.1515","volume":"64","author":[{"given":"Cihan","family":"Beri","sequence":"first","affiliation":[{"name":"Institute of Laboratory Medicine , Philipps University Marburg , Marburg , Germany"},{"name":"Tongji University School of Medicine , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doortje","family":"Engel","sequence":"additional","affiliation":[{"name":"Dr. Risch Medical Laboratory, Sonic Suisse , Vaduz , Liechtenstein"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Risch","sequence":"additional","affiliation":[{"name":"Dr. Risch Medical Laboratory, Sonic Suisse , Vaduz , Liechtenstein"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2692-6699","authenticated-orcid":false,"given":"Lorenz","family":"Risch","sequence":"additional","affiliation":[{"name":"Dr. Risch Medical Laboratory, Sonic Suisse , Vaduz , Liechtenstein"},{"name":"Institute for Laboratory Medicine , Private University in the Principality of Liechtenstein , Triesen , Liechtenstein"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Renz","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine , Philipps University Marburg , Marburg , Germany"},{"name":"Tongji University School of Medicine , Shanghai , China"},{"name":"Institute for Laboratory Medicine , Private University in the Principality of Liechtenstein , Triesen , Liechtenstein"},{"name":"Kilimanjaro Christian Medical University , Moshi , Tanzania , Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"2026110211032900081_j_cclm-2026-0358_ref_001","doi-asserted-by":"crossref","unstructured":"Rohr, U-P, Binder, C, Dieterle, T, Giusti, F, Messina, CGM, Toerien, E, et al.. 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