Guide to Clinical Preventative Services 2009 [UnitedVRG].pdf

Preface:
The U.S. Preventive Services Task Force (USPSTF)
is celebrating its 25th anniversary! Since 1984, the
USPSTF has been conducting rigorous reviews of
research evidence to create evidence-based
recommendations for preventive services that should be
provided in the primary care setting.
Over this quarter century of work, the USPSTF has
made and maintained more than 65 separate
recommendations covering services that are intended
to improve health outcomes from heart disease, cancer,
infectious diseases, and other conditions and events
that impact the health of children, adolescents, adults,
and pregnant women.
The use of these recommendations has evolved over
time. The suggestion that it is not beneficial to
provide all of the services available for prevention was
nearly a heretical concept in U.S. medical practice
when the first USPSTF started its work. Over time,
individual health care providers, professional
organizations, integrated health systems, health plans
and insurers, and public programs, including CMS as
well as groups crafting health quality measures and
national health objectives, have adopted the
recommendations. In 1984, the USPSTF was
convened by the Department of Health and Human
Services’ Assistant Secretary for Health and charged
with reviewing the scientific evidence for clinical
preventive services and developing evidence-based
recommendations for the health care community. The
primary audience for the USPSTF’s work remains
primary care clinicians, and the recommendations are
now considered by many to provide definitive
standards for preventive services.
Our methods also have evolved over time. Today,
the USPSTF evaluates the quality and strength of the
evidence for the service, the net health benefit
(benefit minus harms) associated with the service, and
the level of certainty that this level of benefit will be
realized if these services are provided in primary care.
This process is outlined in our Procedure Manual,
which can be found at http://www.ahrq.gov/clinic/
uspstf08/methods/procmanual.htm.
All recommendation are linked to a letter grade
that reflects the magnitude of net benefit and the
strength and certainty of the evidence supporting the
provision of a specific preventive service. The
recommendation is graded from “A” (recommended)
to “D” (recommended against). The Task Force gives
an “I” grade when the evidence is insufficient to
determine net benefit. These grades translate to
practice guidance for clinicians:
• Offer or provide services with “A” and “B”
recommendations to eligible patients.
• Discourage the use of services with “D”
recommendations.
• Offer or provide services with “C”
recommendations only if other considerations
support this for an individual patient.
• For services with “I” statements, carefully read
the Clinical Considerations section for guidance,
and help patients understand the uncertainty
surrounding these services.
The USPSTF realizes that clinical decisions about
patients involve more complex considerations than
the evidence alone; clinicians should always
understand the evidence but individualize
decisionmaking with the specific patient and
situation. The Clinical Considerations section of
each USPSTF Recommendation Statement helps
clinicians implement the recommendations by
offering practical information so they can tailor these
recommendations to individual patients.
The Guide to Clinical Preventive Services 2009 is a
compilation of abridged USPSTF recommendations
released from 2002 to March 2009 and can be used
as an evidence-based tool at the point of patient care.
Some recommendations have been updated from
those made by the USPSTF in previous years, while
others address preventive services not previously
considered by the USPSTF. Recommendations that
were being updated while this edition of the Guide
was being compiled, as well as the complete
USPSTF recommendation statements, are available
along with their supporting scientific evidence at
http://www.preventiveservices.ahrq.gov.
As is true of all patient care, preventive services
have become much more complex in view of
ongoing research. While providers and their patients
are looking for simple messages and actions, our
recommendations reflect the advances in knowledge
in this critical area of health services, and in order
to maximize the health benefit and decrease any
health harms, we must take the new complexity
into consideration as we do for all medical services
we provide. I strongly encourage clinicians to visit
the Web site and read the complete
recommendation statements for those services they
provide in their practice settings, as the additional
information can be useful in providing the highest
quality preventive care. In addition, the USPSTF
Electronic Preventive Services Selector (ePSS),
available via PDA or on the Web at
http://epss.ahrq.gov, allows users to search USPSTF
recommendations by patient age and other clinical
characteristics.
I hope you find The Guide to Clinical Preventive
Services 2009 to be a useful tool as you care for
patients. I am confident that by implementing
these recommended services, you will help your
patients live longer and healthier lives.
Ned Calonge, M.D., M.P.H.
Chair, U.S. Preventive Services Task Force


Copyright to the respective owners.If you like this book then please buy it.
Sharing is caring,Seed this torrent so others could enjoy it too.
Any requests/suggestions can be made in the comments section or via email to muhammad.waqar.abbas@live.com
Thanks for seeders and supporters!!