RESEARCH ARTICLE Choosing Wisely for apheresis Laura Connelly-Smith 1 | Yvette C. Tanhehco 2 | Vishesh Chhibber 3 | Meghan Delaney 4 | Quentin Eichbaum 5 | Christine Fernandez 6 | Sarita Joshi 7 | Joseph Schwartz 2 | Michael Linenberger 1 1 University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington 2 Columbia University Irving Medical Center, New York, New York 3 Northwell Health, Manhasset, New York 4 Children's National Health System, Washington, District of Columbia 5 Vanderbilt University, Nashville, Tennessee 6 Consultant, Denver, Colorado 7 Cleveland Clinic Foundation, Cleveland, Ohio Correspondence Dr Michael Linenberger, Fred Hutchinson Cancer Research Center (D5280), 1100 Fairview Avenue N. Seattle, WA 98109. Email: linen@u.washington.edu Abstract The Choosing Wisely campaign has stimulated clinicians to think about the appro- priateness of various tests and procedures, compelling physicians to make smarter, safer and more effective choices for high quality patient care and to reduce health- care cost. The American Society for Apheresis (ASFA) strives to advance apheresis medicine through education, evidence-based practice, research and advocacy. To complement these shared missions, ASFA created a working group, consisting of representatives from the various ASFA committees, to produce recommendations for apheresis medicine that reflect the Choosing Wisely guiding principles. A diverse group of ASFA physician and allied health members reviewed, rated and ranked 9 original draft proposals. Additional revisions and refinements were made prior to external review and adoption of five final recommendations by the ASFA Board of Directors. The ASFA Choosing Wisely recommendations encourage apheresis practitioners, patients and donors to discuss and prioritize best clinical practices that avoid harm and waste while optimizing clinical benefit. KEYWORDS choosing wisely, coagulation tests, red blood cell exchange, therapeutic plasma exchange, venous access 1 | INTRODUCTION Choosing Wisely is an initiative of the American Board of Internal Medicine (ABIM) Foundation that seeks to advance dialog between patients and physicians on avoiding unneces- sary medical tests, treatments and procedures. 1 This initiative was initially sparked by a “Perspective” article published in 2010, calling on U.S. medical specialty societies to identify five tests and treatments that were overused in their specialty and did not provide meaningful benefit for patients. 2 Some estimates suggest that as much as 30% of all health care spending is wasted. 3 In 2012, the ABIM Foundation and Consumer Reports launched the Choosing Wisely campaign, inspired by the idea that professional societies and health care providers should take the lead in defining and motivat- ing efforts to reduce the use of low-value care. 4,5 Since its launch, the Choosing Wisely campaign has grown rapidly and spread to 20 countries, with over 70 par- ticipating medical societies. 5 Multiple national organizations representing various medical specialties have identified tests or procedures commonly used in their field whose necessity should be questioned. The American Society for Apheresis (ASFA) is an orga- nization comprised of health care professionals involved in apheresis from 45 states across America and in 35 countries around the world. The mission of ASFA is to advance aphe- resis medicine through education, evidence-based practice, research and advocacy. The collaboration was formed between ASFA and the ABIM Foundation’s Choosing Wisely initiative in 2016 to develop a list of 5 overused apheresis practices that should prompt discussion between patients and physicians. This manuscript describes the process and methodology used by ASFA to develop final recommendations for Choosing Wisely. Laura Conelly Smith and Yvette C. Tanhehco contributed equally to this study. Received: 29 March 2018 Revised: 22 May 2018 Accepted: 1 June 2018 DOI: 10.1002/jca.21643 576 © 2018 Wiley Periodicals, Inc. wileyonlinelibrary.com/journal/jca J Clin Apher. 2018;33:576–579.