Clinicians need to perform better on certain oncology-related Choosing Wisely recommendations, according to an analysis involving 341 such recommendations. Investigators looked at Choosing Wisely measures from 2013, 2014, and 2015, evaluating concordance rates and changes over time, as well as practice variability. Among the results:

• Concordance was best with the measure addressing patients with low or undocumented performance status who received chemotherapy, ranging between 78% and 83%.
• Concordance was worst with the measure involving use of biomarkers or advanced imaging tests for surveillance in early breast cancer, ranging between 68% and 74%.
• Performance on measures varied noticeably by individual practice.
• Variability continued over time.