Avoid advanced hematological diagnostics—such as cytogenetics, molecular pathology, and flow cytometry—in patients where potential findings would not have therapeutic consequences, for example due to advanced age, frailty or comorbidity

Rationale:

Such investigations may cause discomfort for the patient and are resource-intensive both to perform and analyze. They should be avoided if the results are not expected to influence treatment decisions or follow-up.

References: 

• Choosing Wisely International. Do not recommend tests, treatments or procedures that will not change the patient’s clinical course. Choosing Wisely Italy; 2023.
• Chin-Yee B, Seftel MD, Lazo-Langner A, mfl. Choosing Wisely Together: Shared responsibility in hematology and oncology. JCO Oncology Practice. 2024
• American Society for Clinical Pathology. Choosing Wisely recommendation: Do not perform peripheral blood flow cytometry to screen for hematologic malignancy in the absence of clinical suspicion. 2018.