Competing interests: We have read and understood BMJ policy on declaration of interests and have the following interests to declare: KB is paid in her role as knowledge translation lead at Choosing Wisely Canada. WL is paid for her role as chair of Choosing Wisely Canada. KB and WL previously received grant funding from the Commonwealth Fund to support the Choosing Wisely international collaboration. TK received grant funding from the Netherlands Organisation for Health Research and Development (ZonMw) to organise and coordinate the national de-implementation programme To Do Or Not To Do? Provenance and peer review: Not commissioned; externally peer reviewed.