Low-Value Care: Convergence and Challenges; Comment on “Key Factors That Promote Low-Value Care: Views From Experts From the United States, Canada, and the Netherlands”

Document Type : Commentary


1 Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden

2 Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden

3 Unit for implementation and evaluation, Center for Epidemiology and Community Medicine (CES), Stockholm, Sweden


Interest has increased in the topic of de-implementation, ie, reducing so-called low-value care (LVC). The article “Key Factors That Promote Low-Value Care: Views From Experts From the United States, Canada, and the Netherlands” by Verkerk and colleagues identifies national-level factors affecting LVC use in those three countries. This commentary raises three critical points regarding the study. First, the study does not clearly define the national level. Secondly, national-level factors might not be relevant for all types of LVCs and thirdly, the study’s rather limited sample makes it difficult to draw firm conclusions. We also include some critical comments related to some of the study’s findings in relation to results of our recently published scoping review of the international literature on de-implementation and use of LVC and an interview study with primary care physicians on LVC use. Finally, we provide some suggestions for further research that we believe is needed to improve understanding of LVC use and facilitate its de-implementation.


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Volume 11, Issue 11
November 2022
Pages 2762-2764
  • Receive Date: 21 December 2021
  • Revise Date: 30 September 2022
  • Accept Date: 19 October 2022
  • First Publish Date: 22 October 2022