Module 3:Evidence-based Prevention: Applying the USPSTF Guidelines
Developed through the APTR Initiative to Enhance Prevention and Population Health Education in collaboration with the Brody School of Medicine at East Carolina University with funding from the Centers for Disease Control and Prevention
Acknowledgments
APTR wishes to acknowledge the following individual that developed this module:
Suzanne Lazorick, MD, MPHDepartments of Pediatrics and Public HealthBrody School of Medicine at East Carolina University
This education module is made possible through the Centers for Disease Control and Prevention (CDC) and the Association for Prevention Teaching and Research (APTR) Cooperative Agreement, No. 5U50CD300860. The module represents the opinions of the author(s) and does not necessarily represent the views of the Centers for Disease Control and Prevention or the Association for Prevention Teaching and Research.
Presentation Objectives
1. Explain the role of the US Preventive Services Task Force (USPSTF) in improving health outcomes
2. Become familiar with available resources and support tools for evidence-based prevention
1. Online tools including widget2. Applications for mobile devices
Resources
Guide to Clinical Preventive Services http://www.ahrq.gov/clinic/cps3dix.htm
US Preventive Services Task Force http://www.ahrq.gov/clinic/uspstfix.htm
Electronic Preventive Services Selector (ePSS) http://www.ahrq.gov/PDA/index.jsp
US Preventive Services Task Force (USPSTF)Mission
Evaluate the benefits of individual services based on age, gender, and risk factors for disease
Make recommendations about which preventive services should be incorporated routinely into primary medical care and for which populations
Identify a research agenda for clinical preventive care
USPSTFProcess Basics
Conduct scientific evidence reviews of clinical preventive services
Estimate the magnitude of benefits and harms for each preventive service and determines the net benefit
Issue a recommendation
USPSTF Strength of Evidence
The Task Force grades the strength of the evidence: "A" (strongly recommends) "B" (recommends) "C" (no recommendation for or against) "D" (recommends against) "I" (insufficient evidence to recommend for or against).
Obesity in Children and AdolescentsExample of USPSTF Screening Recommendations
In January 2010, the USPSTF issued an update to the July 2005 recommendations on screening and interventions for overweight in children and adolescents.
Recommendation based on targeted systematic review of 13 studies of behavioral intervention in 1258 obese children and adolescents
Current research suggests that behavioral interventions can be effective in managing weight in obese children and adolescents.
Combined behavioral-pharmacological interventions may be useful in very obese adolescents, particularly if research confirms that weight loss is maintained.
Obesity in Children and AdolescentsTargeted Systematic Review for Treatment
Summary of the USPSTF Recommendation
Supporting Article
“Effectiveness of Weight Management Interventions in Children: A Targeted Systematic Review for the USPSTF”
CONCLUSIONS: Over the past several years, research into weight management in obese children and adolescents has improved in quality and quantity. Despite important gaps, available research supports at least short-term benefits of comprehensive medium- to high-intensity behavioral interventions in obese children and adolescents. Pediatrics 2010;125:e396–e418
Additional USPSTF Information
Full Recommendation Statement, Supporting Article, Evidence Synthesis, and Clinical Summary found online:
http://www.ahrq.gov/clinic/uspstf/uspschobes.htm
Electronic Preventive Services Selector (ePSS)
Abraham Flexner, 1910
ePSS Online Form
ePSS Online Form Filled In
Recommendations
Not Recommended
Uncertain
ePSS Widget for Website Use
iPhone/Blackberry Input
iPhone/Blackberry Output
Summary
The USPSTF provides graded recommendations for clinical preventive services based on an extensive review of the evidence.
Support tools to quickly determine an individuals needed services include: Age-Specific Preventive History cards as described in
Module 3A ePSS provided via AHRQ website
▪ All that needs to be entered are: patient’s age, gender and Y/N for use of tobacco and sexual activity
Also available as application for mobile devices
Collaborating Institutions
Center for Public Health Continuing EducationUniversity at Albany School of Public Health
Department of Community & Family MedicineDuke University School of Medicine
Advisory Committee
Mike Barry, CAELorrie Basnight, MDNancy Bennett, MD, MSRuth Gaare Bernheim, JD, MPHAmber Berrian, MPHJames Cawley, MPH, PA-CJack Dillenberg, DDS, MPHKristine Gebbie, RN, DrPHAsim Jani, MD, MPH, FACP
Denise Koo, MD, MPHSuzanne Lazorick, MD, MPHRika Maeshiro, MD, MPHDan Mareck, MDSteve McCurdy, MD, MPHSusan M. Meyer, PhDSallie Rixey, MD, MEdNawraz Shawir, MBBS
APTR
Sharon Hull, MD, MPHPresident
Allison L. LewisExecutive Director
O. Kent Nordvig, MEdProject Representative