Clinical Preventive Services for Women Closing the Gaps (2011) / Chapter Skim
Currently Skimming:
4 Committee Methodology
4 Committee Methodology
Pages 67-78
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 67... ...
The second step was to assemble and assess additional evidence, including reviews of the literature, federal health priority goals and objectives, federal reimbursement policies, and professional clinical guidelines. The committee also considered comments submitted by the public.
|
From page 68... ...
For example, the Grade B recommendation for screening for depression could be interpreted to be universal screening, under the assumption that the primary care provider offices offering the service have adequate staff in place to support the correct delivery of the service, or the USPSTF's recommendation could be interpreted narrowly to include screening only in those practices that have a certified depression screening quality assurance program in place. Thus, after a review of the supporting evidence that led to their recommendations, the committee decided that it was important to note its interpretation of the Grade A and B recommendations in those cases in which specific aspects of the recommendation were found to be ambiguous (see Table 5-1)
|
From page 69... ...
CHD risk assessment The USPSTF concludes that the evidence is insufficient I to assess the balance of benefits and harms of using the nontraditional risk factors discussed in this statement to screen asymptomatic men and women with no history of CHD to prevent CHD events CHD screening The USPSTF found insufficient evidence to recommend I for or against routine screening with resting electrocardiography (ECG) , exercise treadmill test (ETT)
|
From page 70... ...
Drug use screening The USPSTF concludes that the current evidence is I insufficient to assess the balance of benefits and harms of screening adolescents, adults, and pregnant women for illicit drug use. Family violence The USPSTF found insufficient evidence to recommend I screening for or against routine screening of parents or guardians for the physical abuse or neglect of children, of women for intimate partner violence, or of older adults or their caregivers for elder abuse.
|
From page 71... ...
Skin cancer screening The USPSTF concludes that the current evidence is I insufficient to assess the balance of benefits and harms of using a whole-body skin examination by a primary care clinician or patient skin self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population. Suicide risk screening The USPSTF concludes that the evidence is insufficient to I recommend for or against routine screening by primary care clinicians to detect suicide risk in the general population.
|
From page 72... ...
REVIEW OF BRIGHT FUTURES RECOMMENDATIONS The committee reviewed all Bright Futures guidelines and compared them with the USPSTF guidelines for adolescents. The committee noted that the methodology that Bright Futures uses to develop recommendations is considered "evidence informed" and includes expert opinion.
|
From page 73... ...
. For the committee, the principal challenge in identifying preventive services to supplement the guidance from Bright Futures was to disaggregate the health supervision visits recommended by Bright Futures and some of its anticipatory guidance into conditions and preventive measures fitting the committee's overall approach.
|
From page 74... ...
. Finally, the committee also used the 2011 IOM report Leading Health Indicators for Healthy People 2020 as a tool to perform horizon scanning or examine priority goals and/ or persistent trends relating to women's health and well-being to identify potential gaps (IOM, 2011)
|
From page 75... ...
These two issues are discussed below. Reviews of Clinical Effectiveness Assessment of the efficacy and effectiveness of preventive measures to provide clinical guidance was one of the topics of clinical focus that, more than 30 years ago, launched the change in the approach to health care delivery that is now called evidence-based medicine.
|
From page 76... ...
Finally, because cost was explicitly excluded as a factor that the committee could use in forming recommendations, the committee process could not evaluate preventive services on the basis of cost. Against this background, the committee selected a hybrid approach that collected relevant evidence for each measure, and it determined that the question of a methodology to fully address insurance coverage was beyond its scope.
|
From page 77... ...
In general, preventive measures recommended by the committee met the following criteria: • The condition to be prevented affects a broad population; • The condition to be prevented has a large potential impact on health and well-being; and • The quality and strength of the evidence is supportive. Ultimately, the decision to develop a recommendation for a preventive measure or service was made after a thoughtful review and debate of each of the subcommittee's reports.
|
From page 78... ...
Rockville, MD: United States Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/uspstopics.htm (accessed May 31, 2011)
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.