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In Reply We strongly agree with several points in Mr Wolfson’s letter. As Mr Wolfson states, our study1 is an early marker of the uptake of the Choosing Wisely campaign among clinicians, and we agree that reducing inappropriate utilization will take a concerted effort by those in delivery systems and in local communities. We also agree that a follow-up period of 18 months is a small window through which to observe widespread changes in practice. It is possible that an analysis with a longer follow-up period and inclusion of more than 7 Choosing Wisely recommendations could show a greater effect. To that end, the letter from Dr Crawford and colleagues summarizes efforts to refine and continue the trend analysis over time and should be commended as another next step in this important effort.
Agiro A, DeVries A, Rosenberg A. Choosing Wisely Recommendations Using Administrative Claims Data—Reply. JAMA Intern Med. 2016;176(4):566. doi:10.1001/jamainternmed.2016.0371