RT Journal Article SR Electronic T1 Choosing Wisely: The Canadian Rheumatology Association’s List of 5 Items Physicians and Patients Should Question JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP 682 OP 689 DO 10.3899/jrheum.141140 VO 42 IS 4 A1 Shirley L. Chow A1 J. Carter Thorne A1 Mary J. Bell A1 Robert Ferrari A1 Zarnaz Bagheri A1 Tristan Boyd A1 Ann Marie Colwill A1 Michelle Jung A1 Damian Frackowiak A1 Glen S. Hazlewood A1 Bindee Kuriya A1 Peter Tugwell YR 2015 UL http://www.jrheum.org/content/42/4/682.abstract AB Objective. To develop a list of 5 tests or treatments used in rheumatology that have evidence indicating that they may be unnecessary and thus should be reevaluated by rheumatology healthcare providers and patients. Methods. Using the Delphi method, a committee of 16 rheumatologists from across Canada and an allied health professional generated a list of tests, procedures, or treatments in rheumatology that may be unnecessary, nonspecific, or insensitive. Items with high content agreement and perceived relevance advanced to a survey of Canadian Rheumatology Association (CRA) members. CRA members ranked these top items based on content agreement, effect, and item ranking. A methodology subcommittee discussed the items in light of their relevance to rheumatology, potential effect on patients, and the member survey results. Five candidate items selected were then subjected to a literature review. A group of patient collaborators with rheumatic diseases also reviewed these items. Results. Sixty-four unique items were proposed and after 3 Delphi rounds, this list was narrowed down to 13 items. In the member-wide survey, 172 rheumatologists responded (36% of those contacted). The respondent characteristics were similar to the membership at large in terms of sex and geographical distribution. Five topics (antinuclear antibodies testing, HLA-B27 testing, bone density testing, bone scans, and bisphosphonate use) with high ratings on agreement and effect were chosen for literature review. Conclusion. The list of 5 items has identified starting points to promote discussion about practices that should be questioned to assist rheumatology healthcare providers in delivering high-quality care.