Clinical Preventive Services for Women Closing the Gaps (2011) / Chapter Skim
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2 Preventive Services Defined by the ACA
2 Preventive Services Defined by the ACA
Pages 29-46
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A summary of the methods that these entities use to arrive at recommendations and the actual recommendations follows. UNITED STATES PREVENTIVE SERVICES TASK FORCE The Task Force is an independent panel composed of nonfederal primary care clinicians, health behavior specialists, and methodologists.
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service. B The USPSTF recommends the service.
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. They contribute expertise to the evaluation process and comment on preliminary drafts of Task Force recommendation statements and the accompanying evidence reports.
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7. Development of Draft Recommendation Statement -- USPSTF, AHRQ Concomitant with the draft evidence report review process, Task Force leads collaborate with the AHRQ Medical Officer to discuss and draft a preliminary recommendation statement.
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11. Approval of Final Recommendation Statement -- USPSTF Task Force leads edit the recommendation statement on the basis of the comments received from the federal and primary care professional organization partners and the public after discussion with the AHRQ Medical Officer.
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Bacteriuria screening: The USPSTF recommends screening for A pregnant women asymptomatic bacteriuria with urine culture for pregnant women at 12 to 16 weeks' gestation or at the first prenatal visit, if later. Blood pressure screening The USPSTF recommends screening for A high blood pressure in adults aged 18 and older.
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Chlamydial infection The USPSTF recommends screening for B screening: pregnant women chlamydial infection for all pregnant women aged 24 and younger and for older pregnant women who are at increased risk. Cholesterol abnormalities The USPSTF strongly recommends A screening: women 45 and screening women aged 45 and older older for lipid disorders if they are at increased risk for coronary heart disease.
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Obesity screening and The USPSTF recommends that clinicians B counseling: adults screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults. Osteoporosis screening: The USPSTF recommends screening for B women osteoporosis in women aged 65 years or older and in younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors.
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Syphilis screening: non- The USPSTF strongly recommends that A pregnant persons clinicians screen persons at increased risk for syphilis infection. Syphilis screening: pregnant The USPSTF recommends that clinicians A women screen all pregnant women for syphilis infection.
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2. A Bright Futures Evidence Panel, composed of consultants who are experts in finding and evaluating evidence from clinical studies, was convened to examine studies and systematic evidence reviews and to develop a method of informing readers about the strength of the evidence.
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In addition to the information in the tables shown in Figures 2-1 to 2-3, Bright Futures also provides extensive anticipatory guidance on a range of health matters in the context of discussing health issues with adolescents. These measures do not provide action steps and are not suitable for summary in a structured format.
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SELECTIVE SCREENING RISK ASSESSMENT* ACTION IF RA + Vision at other ages + on risk screening questions Snellen test Hearing + on risk screening questions Audiometry Anemia + on risk screening questions Hemoglobin or hematocrit Tuberculosis + on risk screening questions Tuberculin skin test + on risk screening questions and not Lipid screen Dyslipidemia previously screened with normal results STIs Sexually active Screen for chlamydia and gonorrhea; use tests appropriate to the patient population and clinical setting Sexually active and + on risk questions Syphilis blood test HIV† Sexually active without contraception, Urine hCG Pregnancy late menses, or amenorrhea Sexually active, within 3 years of Pap smear, conventional slide Cervical dysplasia onset of sexual activity or liquid-based Alcohol or drug use + on risk screening questions Administer alcohol and drug screening tool *
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Snellen test SELECTIVE SCREENING RISK ASSESSMENT* ACTION IF RA + Vision at other ages + on risk screening questions Snellen test Hearing + on risk screening questions Audiometry Anemia + on risk screening questions Hemoglobin or hematocrit Tuberculosis + on risk screening questions Tuberculin skin test + on risk screening questions and not Lipid screen Dyslipidemia previously screened with normal results STIs Sexually active Screen for chlamydia and gonorrhea; use tests appropriate to the patient population and clinical setting Sexually active and + on risk questions Syphilis blood test HIV† Sexually active without contraception, Urine hCG Pregnancy late menses, or amenorrhea Sexually active, within 3 years of Pap smear, conventional slide Cervical dysplasia onset of sexual activity or liquid-based Alcohol or drug use + on risk screening questions Administer alcohol and drug screening tool *
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SELECTIVE SCREENING RISK ASSESSMENT* ACTION IF RA + Vision at other ages + on risk screening questions Snellen test Hearing + on risk screening questions Audiometry Anemia + on risk screening questions Hemoglobin or hematocrit Tuberculosis + on risk screening questions Tuberculin skin test If not age 20, + on risk screening Lipid screen Dyslipidemia questions and not previously screeened with normal resaults STIs Sexually active Screen for chlamydia and gonorrhea; use tests appropriate to the patient population and clinical setting Sexually active and + on risk questions Syphilis blood test HIV† Sexually active without contraception, Urine hCG Pregnancy late or absent menses, or heavy or irregular bleeding Sexually active, within 3 years of Pap smear, conventional slide Cervical dysplasia onset of sexual activity or liquid-based Alcohol or drug use + on risk screening questions Administer alcohol and drug screening tool *
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These analyses include review of the available scientific literature on the immunizing agent, morbidity and mortality from the disease in the U.S. population, recommendation statements issued by other professional organizations, results of clinical trials with the immunizing agent, cost-effectiveness projections, and the feasibility of incorporating the vaccine into preexisting U.S.
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TABLE 2-3 FDA-Licensed Combination Vaccines Trade Name Vaccine (Year Licensed) Age Range Routinely Recommended Ages ≥18 years HepA-HepB Twinrix (2001)
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When combination vaccines, the minimum age for administration is the oldest age for any of the individual components; the minimum interval between doses is equal to the greatest interval of any of the individual components. Information on traveler vaccines, including typhoid, Japanese encephalitis, and yellow fever, is available at http://www.cdc.gov/travel.
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Rockville, MD: United States Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/uspstf/uspsabrecs.htm (accessed June 2, 2011)
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