2012 Top Five List

ASCO Volunteers Explain the Importance of the Top Five List
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Choosing Wisely®: ASCO Identifies Five Key Opportunities in Oncology to Improve Value of Patient Care

As a participant in the American Board of Internal Medicine Foundation’s Choosing Wisely® campaign, ASCO has issued a “Top Five” list of common, costly procedures in oncology that are not supported by evidence and that should be questioned. In addition to the Top Five list, a full manuscript further detailing the background, methods, and results of ASCO’s efforts is published in the Journal of Clinical Oncology.

The development of the list for oncology was led by ASCO’s Cost of Cancer Care Task Force, a multidisciplinary group of oncologists committed to addressing the underlying issues contributing to the rising cost of cancer care. Selections were based on a comprehensive review of published studies and current guidelines from ASCO and other organizations. The final list also reflects input from more than 200 oncologists, including the society’s Clinical Practice Committee, the leadership of the state/regional oncology societies, as well as other leading oncologists and patient advocates.

The resulting list for the field of oncology affirms that evidence-based medicine is the key to providing high-quality, high-value care to our patients.

The concept for the Top Five list was first proposed in 2010 by Howard Brody, MD, PhD in a New England Journal of Medicine commentary. Dr. Brody challenged medical specialties to take a critical look at their fields, and to each identify five costly practices that are commonly performed despite lack evidence.

"The fact is that today’s growing healthcare costs are unsustainable. As oncologists, we have a responsibility to provide our patients with high value cancer care. That means providing the highest quality care to our patients while avoiding costly tests and procedures that have little or no proven benefit," said Michael P. Link, MD, president of ASCO.

"By working together to reduce the overuse of these procedures, the oncology field can help improve the care of our patients, while achieving substantial cost savings" said Lowell E. Schnipper, MD, chair of ASCO’s Cost of Cancer Care Task Force. "This list will help oncologists and their patients make more informed decisions about their care."

In addition to the physician and patient resources released in conjunction with the launch of the Choosing Wisely campaign, over the coming months, ASCO will provide additional resources to help educate our members regarding the Top Five recommendations and encourage honest conversations with patients.

For questions, please contact topfive@asco.org.