A total of 5209 articles were screened for eligibility, resulting in 156 potentially ineffective and/or unsafe services being identified for consideration. The list includes examples where practice optimisation (ie, assessing relative value of a service against comparators) might be required.
The list of health care services produced provides a launchpad for expert clinical detailing. Exploring the dimensions of how, and under what circumstances, the appropriateness of certain services has fallen into question, will allow prioritisation within health technology reassessment initiatives.
The article is here, and the list is in an appendix. All entries are sourced. Not all of them are of zero value for all people, but all are of low to no value to some to whom they are provided. A straightforward and useful research project would be to estimate U.S. expenditure for each service, possibly stratified by payer (Medicare, commercial market, etc.). One could also contemplate geographic variation.