Volume 40 Number 1 | February 2026
Summary

This article outlines how ASCLS members can advance diagnostic stewardship by submitting evidence-based test utilization recommendations. It traces the evolution from Choosing Wisely to Effective Test Utilization, explains submission criteria and review steps, and encourages laboratorians to help reduce misuse, improve patient safety, and promote high‑value care.

What ASCLS Members Need to Know

Katrina (Kate) Moreau, MPH, MAT, MLS(ASCP)CM, ASCLS Patient Safety and Diagnostic Stewardship Committee Past Chair

Katrina (Kate) MoreauThe saying, “The right test for the right patient at the right time,” is a guiding principle in healthcare and laboratory medicine. It reflects our commitment to delivering high-quality, patient-centered, and efficient health care while improving patient safety and outcomes and avoiding unnecessary costs. In 2012, the American Board of Internal Medicine (ABIM) waged a decade long campaign called Choosing Wisely (CW) meant to initiate conversations between patients and clinicians about the necessity of medical tests and treatments. The American Society for Clinical Pathology (ASCP) was an early member of this campaign, and in 2020 ASCLS and the American Society for Microbiology (ASM) joined the efforts, which led to the creation of an ASCLS Choosing Wisely Committee.

Overtime, participation grew from nine to 80 specialty organizations that provided recommendations on common practices that lacked evidence of value. Collectively, ASCP, ASCLS, and ASM provided 35 recommendations for overused laboratory tests, which were published between 2014-2020.1 After a slight slow-down during the COVID pandemic, the CW campaign came to a close, and professional organizations were encouraged to publish their own individual lists. Diagnostic stewardship continued via the transition from Choosing Wisely to Effective Test Utilization lists and workgroups.2

Within ASCLS there were two committees, Patient Safety and Choosing Wisely, both of which played a role in providing tools, resources, and educational materials to improve safety for all patients served. In 2024, the two committees merged and became what is now known as the Patient Safety and Diagnostic Stewardship Committee (PS&DSC). One of the several charges for our committee is to continue the important work initiated by CW by maintaining an internal evaluation process for test recommendations.

“We can all be diagnostic stewards and collectively support our profession’s efforts to ensure that the right patient receives the right test, at the right time, and for the right reason.”

Any ASCLS member can submit a test recommendation for review.

You do not need to be a member of the PS&DS Committee. It is important to consider the following criteria when considering whether a test recommendation is based on evidence of misuse2:

  • It is a frequently performed test.
  • There is evidence that the test either offers no benefit or is harmful (either entirely or in specific clinical situations).
  • The test is costly, and it does not provide higher quality care.
  • Eliminating the test or changing to another test is within the control of the clinician.

If the test recommendation has not been previously published in ASCP Choosing Wisely or the Effective Test Utilization Catalog, ASCLS members may consider submitting it through the ASCLS Effective Test Utilization (ETU) review process. There is no deadline for submission to the ASCLS PS&DS Committee; however, there is an annual call for submissions from ASCP which maintains the published list; this has historically been between February and April.

Guidelines for Test Recommendation Submissions to the PS&DS Committee:
  • Ensure the test recommendation has not been previously published in the ASCP Effective Test Utilization Catalog.
  • Draft your test recommendation and include a title (</= 15 words), justification (<300 words), and relevant citations (1-5).
  • Email test recommendation and sources to the Patient Safety and Diagnostic Stewardship Committee chair (currently Darby Naheedy) via ASCLS Connect.
  • The PS&DS Committee chair will forward the test recommendation to the Effective Test Utilization Work Group to initiate the review process.
  • All test recommendations which meet the criteria of clarity, relevancy, efficiency, and value, will then be submitted by the ETU Work Group to the ASCLS Board of Directors for approval prior to submission to ASCP.
  • ASCP will perform an additional internal review prior to acceptance for publication in the Effective Test Utilization online catalog.

Every ASCLS member has the opportunity to improve the utilization of laboratory testing and promote high-value care. If you’ve observed a test that is frequently misused or provides limited clinical benefit in specific circumstances, I encourage you to draft a recommendation and share it with the PS&DS Committee. We can all be diagnostic stewards and collectively support our profession’s efforts to ensure that the right patient receives the right test, at the right time, and for the right reason.

References
  1. American Society for Clinical Pathology. Choosing Wisely: 35 Laboratory Test Recommendations. ASCP. Accessed November 25, 2025. https://ascpcontentwebsite.blob.core.windows.net/content/docs/default-source/istp/cw_35recommendations.pdf
  2. American Society for Clinical Pathology. Effective test utilization. ASCP. Accessed November 25, 2025. https://www.ascp.org/news/effective-test-utilization

Katrina (Kate) Moreau is a Clinical Associate Professor at the University of Vermont (UVM) and is the Program Director for Biomedical and Clinical Sciences in Burlington, Vermont.