Standards of care may not consider the variation in resources available in a given location in a given instance.

Many treatments are given to patients who have little to gain from them.

Differences in physician practice styles and availability of resources can lead to variations in delivery of care.

All medical care should seek to achieve one or more of three goals: to prevent future suffering, to relieve suffering, or to prolong life. Detecting low-grade indolent cancer may not further any of these goals.

A digital record of place history and environmental context can provide a piece of clinically relevant information to help physicians understand what toxins patients may have been exposed to.

A distinguishing feature of a SCAMP is its ability to capture knowledge-based diversions from a recommended pathway and to “learn” from such individualized patient management.

It is an understandable human reaction to feel defensive in the face of evidence that challenges one's practices, but it is imperative that we rise above this with a modicum of humility and ask the tough questions: what causes problems and how can we avoid them in the future?

Nonmaleficence must not be sacrificed in the name of the patient’s autonomy, but there is no need to undertake needlessly invasive treatments for a small boost in protection against cancer recurrence if the patient does not wish to do so.

Variations in medical practice are far more complex than the simple narrative popularly attributed to the Dartmouth Atlas.

Although not everything on the Choosing Wisely lists is likely to reduce low-value care, it is a good starting point for a conversation about curtailing low-value interventions.