{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:28:41Z","timestamp":1792106921625,"version":"4.4.0"},"reference-count":70,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,10]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>\n                      Estimates suggest that one third of United States health care spending results from overuse or misuse of tests, procedures, and therapies. The American Board of Internal Medicine Foundation, in partnership with\n                      <jats:italic toggle=\"yes\">Consumer Reports<\/jats:italic>\n                      , initiated the \u201cChoosing Wisely\u201d campaign to identify areas in patient care and resource use most open to improvement. Nine subspecialty organizations joined the campaign; each organization identified five tests, procedures, or therapies that are overused, are misused, or could potentially lead to harm or unnecessary health care spending. Each of the American Society of Nephrology\u2019s (ASN\u2019s) 10 advisory groups submitted recommendations for inclusion. The ASN Quality and Patient Safety Task Force selected five recommendations based on relevance and importance to individuals with kidney disease.Recommendations selected were: (\n                      <jats:italic toggle=\"yes\">1<\/jats:italic>\n                      ) Do not perform routine cancer screening for dialysis patients with limited life expectancies without signs or symptoms; (\n                      <jats:italic toggle=\"yes\">2<\/jats:italic>\n                      ) do not administer erythropoiesis-stimulating agents to CKD patients with hemoglobin levels \u226510 g\/dl without symptoms of anemia; (\n                      <jats:italic toggle=\"yes\">3<\/jats:italic>\n                      ) avoid nonsteroidal anti-inflammatory drugs in individuals with hypertension, heart failure, or CKD of all causes, including diabetes; (\n                      <jats:italic toggle=\"yes\">4<\/jats:italic>\n                      ) do not place peripherally inserted central catheters in stage 3\u20135 CKD patients without consulting nephrology; (\n                      <jats:italic toggle=\"yes\">5<\/jats:italic>\n                      ) do not initiate chronic dialysis without ensuring a shared decision-making process between patients, their families, and their physicians.These five recommendations and supporting evidence give providers information to facilitate prudent care decisions and empower patients to actively participate in critical, honest conversations about their care, potentially reducing unnecessary health care spending and preventing harm.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.04970512","type":"journal-article","created":{"date-parts":[[2012,9,15]],"date-time":"2012-09-15T06:26:44Z","timestamp":1347690404000},"page":"1664-1672","source":"Crossref","is-referenced-by-count":167,"title":["Critical and Honest Conversations"],"prefix":"10.2215","volume":"7","author":[{"given":"Amy 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