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Table 1 Search terms (n = 11), definition and/or key reference, and targeted funding opportunity announcements (FOA; n = 3)

From: Studying de-implementation in health: an analysis of funded research grants

Search term Definition and/or key reference
 Choosing Wisely • Initiative that aims to promote conversations between clinicians and patients by helping patients choose care that is supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary [15]
 De-adopt% • Discontinuation of a clinical practice after it was previously adopted [67]
 Decrease use • Reduce intensity and/or frequency of use [21]
 De-implement% • Abandonment [17]
• Reduce (frequency and/or intensity) or stop the delivery of ineffective, unproven, harmful, overused, inappropriate, and/or low-value health services and practices provided to patients by healthcare practitioners and systems [68]
 De-prescrib% • Process of tapering, stopping, discontinuing, or withdrawing drugs, with the goal of managing polypharmacy and improving outcomes [31]
• Process of withdrawal of an inappropriate medication, supervised by a healthcare professional with the goal of managing polypharmacy and improving outcomes [30]
• Planned and supervised process of dose reduction or stopping of medication that may be causing harm or no longer be providing benefit. The goal of de-prescribing is to reduce medication burden and harm while maintaining or improving quality of life
 Disincent% Niven and colleagues [21]
 Disinvest% • Processes of withdrawing (partially or completely) health resources from any existing healthcare practices, procedures, technologies, or pharmaceuticals that are deemed to deliver little or no health gain for their cost and are thus not efficient health resource allocations [32]
 Exnovat% • Exnovation is the process of removal of innovations that do not improve organizational performance, are too disruptive to routine operations, or do not fit well with the existing organizational strategy, incentives, structure, and/or culture [34]
• Removal process at the tail end of the innovation cycle [69]
• Exnovation is different from “de-implementation,” “de-adoption,” and “rejection” in that these terms emphasize the strategic and deliberate removal of organizational structures and processes, whereas exnovation focuses on the removal of innovations specifically [34]
 Low-value • Services that provide little to no clinical benefit on average [20]
• Low-value care can be defined in terms of net benefit, a function of the expected (though uncertain) benefit and cost for an individual or group, and is assessed relative to alternatives, including no treatment [19]
• Potential for harm exceeds the possible benefit [13]
 Medical reversal • Medical reversal occurs when an accepted practice—a diagnostic test, medication, or procedure—is overturned. The practice is not replaced by something better, but shown to be inferior to a preexisting, less intensive, or less invasive one [14, 16]
• Medical reversal occurs when a currently accepted therapy is overturned—found to be no better than the therapy it replaced [18]
• Current practice shown to be ineffective or harmful [21]
 Un-diffus% • Abandoning established practices [35]
FOA Title and mechanisms
 PAR-16-238a • NIH Dissemination and Implementation Research in Health
• R01, R21, R03
 RFA-CA-15-008b • Research Answers to the National Cancer Institute’s Provocative Questions (Question 12)
• R01, R21
 RFA-HL-17-016 • National Heart, Lung, and Blood Institute’s Research Career Development Programs in T4 Implementation Research
• K12
  1. Terms listed in alphabetical order. % = searching all tenses of the base word. Terms were searched in the grant title, abstract, and specific aims. Full citations can be found in the References section
  2. FOA funding opportunity announcement
  3. aMost recent R01 FOA listed. Search includes PARs from all years: PAR-06-039, PAR-07-086, PAR-06-520, PAR-06-521, PAR-10-038, PAR-10-039, PAR-10-040, PAR-13-055, PAR-13-056, PAR-13-054, PAR-16-238, PAR-16-236, PAR-16-237
  4. bMost recent R01 FOA listed. Search includes RFAs from all years: RFA-CA-13-024 (group E, question 3), RFA-CA-13-025 (group E, question 3), RFA-CA-15-008 (question 12), and RFA-CA-15-009 (question 12)