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US Preventive Services Task Force (USPSTF)

USPSTF was created in 1984 is an independent group at national experts in prevention and evidence-based medicine.

The USPSTF makes recommendations about the effectiveness of specific preventive care services for patient without obviously related signs with symptoms to improve the health of people.

Its intent is to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as: screenings, counseling, and preventative medications.

It works improve the health of all US people by developing recommendations about clinical preventive services.

The USPSTF recommendations are based  on the evidence of both benefits and harms and assesses the balance without considering the cost providing a service.

Makes recommendations about the effectiveness of specific preventive care services for patients without obvious related signs or symptoms.

It bases its recommendations on the evidence of both the benefits and harms of the service and assesses the balance.

Reports have a profound influence on clinical practice and delivery of preventive services in the US and around the world.

Most recommendations are supported by and primarily based on evidence reports conducted by the evidence-based practice centers, which are academic research organizations with expertise in conducting evidence reviews, and are commissioned by and supported by the Agency for Healthcare Research and Quality, the sponsoring agency for USPSTF.

Recommendation Statements are graded A,B, C, D.

A recommendation indicates that USPSTF recommends the service and that the net benefit is substantial.

D recommendations the USPSTF recommends against the service, and that there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.

Recommendations I concludes the current evidence is insufficient to assess the balance of benefits and harms of the service.

In Recommendation I evidence is lacking, of poor quality, or conflicting in the balance of benefits and harms cannot be determined.

Levels of certainty:

High-the available evidence usually includes consistent results from well designed, well conducted studies in representative primary care populations. The studies assess the effects of preventive service on health outcomes. This conclusion is therefore unlikely to be strongly affected by the results of future studies.

Moderate-the available evidence is sufficient to determine the effects of the preventive service on health outcomes, but confidence in the estimate is constrained by such factors as: the number, size, or quality of individual studies, inconsistency of findings across individual studies, limited generalizability of findings to routine primary care practice, lack of coherence in the chain of evidence. As more information becomes available, the magnitude and direction of the observed effect could change, and this change may be large enough to alter the conclusion.

Low-the available evidence is insufficient to assess effects on health outcomes. Evidence is insufficient because of the limited number or size of studies, important flaws in study design or methods, inconsistency of findings across individual studies, gaps in the chain of evidence, findings not generalizable to routine primary care practice, lack of information on important health outcomes. More information may allow estimation of effects on health outcomes.

Concludes that evidence is insufficient to assess the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic children.

USPSTF recommends screening women aged 21-29 years for cervical cancer every 3 years with cervical cytology alone, and screening women aged 30-65 years every 5 years with either hrHPV testing alone or in combination with cytology.

USPSTF recommends pre-exposure prophylaxis with effective anti-retroviral therapy in patients at high risk of HIV acquisition.

USPSTF recommends that patients should be screened for HIV infection in adolescents and adults age 15-65 years.

Younger adolescents and older adults who are at increased risk of infection should also be screened.

The USPSTF recommends that patients be screened for HIV infection in all pregnant women, including those who are present at labor or at delivery whose HIV status is unknown.

The USPSTF recommends that women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with BRCA1/2 gene mutations have appropriate BRCA testing.

The USPSTF recommends that all women undergo routine breast cancer screening every other year beginning at age 40 years.

The USPSTF has concluded that the evidence for biennial screening mammography in women age 40 to 74 years has moderate net benefit, and that the evidence is insufficient to determine the balance of benefits and harms of screening mammography in women 75 years or older.

The USPSTF Recommends against screening for ovarian cancer and asymptomatic women.

The USPSTF recommends prescribing risk reducing medications such as tamoxifen, raloxifine, aromatase inhibitors to women who are increased for breast cancer and are at low risk for adverse medication effects.

US Preventive Services Task Force study showed CT screening can reduce lung cancer specific mortality by 62 events for 100,000 person-years and is recommended by the US Preventive Services Task Force for patients age 50-80 years who have a 20 year pack smoking history and currently smoke or quit within the last 15 years.

USPSTF does not recommend screening asymptomatic adults for pancreatic cancer.

USPSTF does not recommend cognitive impairment screening in older adults as there was no evidence that the balance of benefits and harms could be determined.

The USPSTF opposes screening for bacterial vaginosis in pregnant persons not at increased risk for preterm delivery.

 

The USPSTF recommends screening adults ages 18 to 79 years, including pregnant persons who do not have any signs or symptoms of HCV infection and do not have known  liver disease.

The USPSTF recommends all asymptomatic adults age 18-79 years, regardless of risk, to screen for hepatitis C virus.

The USPSTF recommends all asymptomatic adolescents and adults who have an increased risk for infection be screened  for hepatitis B.

The USPSTF recommends screening by asking questions about unhealthy drug use in adults age 18 years or older.

USPSTF has concluded that the current evidence is insufficient to assess the balance of benefits and harms of primary care-based behavioral counseling interventions to prevent illicit drug use, including nonmedical use of prescription drugs in children, adolescents, and young adults.

Screening for colorectal cancer (CRC) should begin at age 45 years instead of 50 years, as recommended in the current guideline, the US Preventive Services Task Force (USPSTF).

The recommendation is that all adults aged 45 to 75 years be screened for CRC.

 

The USPSTF finds there is insufficient evidence to make a recommendation for or against screening for high blood pressure in children and adolescents.

The USPSTF finds there is insufficient evidence to make a recommendation for asymptomatic carotid artery stenosis screening in the general adult population.

 

The USPSTF concluded the current evidence is insufficient to assess the balance of benefits and harms of screening for vitamin D deficiency in asymptomatic adults.

 

The USPSTF recommends that adults age 35-70 years who have overweight or obesity be screened for pre-diabetes and type two diabetes and be offered or referred for a preventive pre-diabetic intervention.

 

The use of low-dose aspirin, 81 mg/day, as a preventive medication for preeclampsia after 12 weeks of gestation in persons who are at high  risk for preeclampsia is recommended by the USPSTF.

USPSTF recommends screening for gestational diabetes in asymptomatic pregnant persons at 24 weeks of gestation or after.

 

The USPSTF recommends screening for chlamydia in all sexually active women 24 years or younger and then women 25 years older who are at increased risk for infection.

The USPSTF recommends screening for gonorrhea and all sexually active women 24 years younger and then women 25 years or older who were eight increase weeks for infection.

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for chlamydia and gonorrhea in men.

The US Preventative Services Task Force concludes that evidence is lacking, and the balance of benefits in harms of screening for age of fibrillation in asymptomatic adults cannot be determined.

US Preventive Services Task Force recommendation statement: The decision to initiate low-dose aspirin use for the primary prevention of cardiovascular disease in adults age 40 to 59 years who have a 10% or greater 10 year cardiovascular disease risk should be an individual one: the benefit of aspirin use in this group is small. Persons who are not an increased risk for bleeding and are willing to take low-dose aspirin daily are more likely to benefit.
The USPSTF recommends against initiating low-dose aspirin for the primary prevention of cardiovascular disease in adults 60 years or older.

The USPSTF recommends against screening for COPD in asymptomatic adults.

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for primary open angle glaucoma in adults.

The USPST has concluded that the current evidence is insufficient to assess the balance of benefits in harms of screening for impaired visual acuity in asymptomatic older results.

The USPTF has concluded that current evidence is insufficient to assess the balance of benefits in harms for the use of multivitamin supplements, single supplements, or most paired supplements for the prevention of cardiovascular disease or cancer.

The USPTF specifically recommends against the use of beta carotene supplements for prevention of cardiovascular disease or cancer, because of possible increased risk of mortality, cardiovascular mortality and lung cancer.

The USPTF specifically recommends against the use of vitamin D supplementation for prevention of cardiovascular disease or cancer because it probably has no net benefit in reducing mortality, cardiovascular disease, or cancer.

The USPSTF reference to multivitamins suggested insufficient evidence for recommendation for or against its use.

The USPSTF recommends against the use of beta carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer.

USPSTF recommends% screening for anxiety in children and adolescents age 8 to 18, but the current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety in children seven years or younger.

USPSTF recommends a statin be prescribed for the primary prevention of CVD  for adults age 40 to 75 years who have had one or more CVD risk factors: dyslipidemia, diabetes, hypertension, or smoking and an estimated 10 year CVD risk of 10% or greater.

USPSTF suggests there is insufficient evidence to access the benefits and harms of screening for type two diabetes in children and adolescents.

The USPSTF concludes that current evidence for screening for major depressive disorders in  adolescents age 12 to 18 is insufficient to assess the balance of benefits and harms.

US Preventive Services Task Force has concluded that the current evidence is insufficient to assess the balance of benefits and harms for population wide screening for skin cancer.

The USPSTF recommends against the use of estrogen with or without progestin for prevention of chronic conditions such as coronary heart disease.

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits in harms of screening for obstructive sleep apnea in the general adult population.

The USPSTF recommends against routine serologic screening for general HSV infection in asymptomatic, adolescents and adults, including pregnant persons.

The USPSTF concludes that routine seroscreening for genital herpes in asymptomatic individuals is not recommended in adolescents, adults, or during pregnancy.

The US PSTF recommends screening for latent tuberculosis infection in populations at increased risk.

The USPSTF recommends screening for depression in the adult population, including pregnant and postpartum persons and older adults.

The USPSTF concludes the current evidence is insufficient to assess the balance of benefits and harms of screening for suicide risk in the adult population.

The USPSTF concludes that the current evidence is insufficient to establish the benefits/harms of screening for lipid disorders in children and adolescents 20 years or younger.

USPSTF recommends that all person plan to, or could become pregnant take a daily supplement of .4 to .8 mg of folic acid, because of the high certainty of substantial net benefit.

The US PSTF recommends that clinicians prescribe preexposure prophylaxis using effective anti-retroviral therapy to persons at increased risk of HIV acquisition to decrease the risk of acquiring HIV.

The USPSTF recommends that all persons planning to or who could become pregnant take a daily supplement containing 0.4 to 0.8 mg of folic acid.

The USPSTF recommends screening for hypertensive disorders in pregnant persons with blood pressure measurements throughout pregnancy.

The USPSTF Has concluded that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions performed by primary care clinicians for oral health conditions, including dental caries, or periodontal related disease in adults.

 

 

 

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