Original Investigation

Low-Value Services and Longitudinal Knowledge Assessment Performance

JAMA Internal Medicine 10.1001/jamainternmed.2026.2889

July 13, 2026 at 11:00 AM EDT

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Is physician general clinical knowledge associated with low-value service (LVS) use?In this cross-sectional study of 7089 outpatient general internists caring for 898 365 Medicare fee-for-service beneficiaries in 2022 or 2023 during their first year of enrollment in the American Board of Internal Medicine’s Longitudinal Knowledge Assessment (LKA), higher first-year LKA scores were associated with fewer patients receiving any of 25 different LVSs during the year.These findings suggest better physician knowledge was associated with lower use of LVSs for Medicare beneficiaries.

Corresponding Author: Jonathan L. Vandergrift, MS, American Board of Internal Medicine, 510 Walnut St, Ste 1700, Philadelphia, PA 19106 (jvandergrift@abim.org).

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