Clinical practice guidelines. USPSTF recommendations.

Abstract

The set of USPSTF recommendations provides a valuable resource for clinicians in varied practice settings. Although the 2nd edition of recommendations addressed over 200 topics, only six statements have been released as part of the 3rd edition thus far. Others, not reviewed in this article include: screening for newborn hearing, screening for bacterial vaginosis during pregnancy, and screening for lipid disorders. The recommendations are conservative and, like all clinical practice guidelines, should be considered in light of one's philosophy of practice. The recommendations meet many of the criteria addressed in the initial column of this series. The factors considered by the panel members are identified, including accuracy of available screening methodologies, cost factors, and benefit/risk determinations. The evidence on which recommendations are based is rated. Exceptions to the recommendations are identified. For instance, the authors of the paper on skin cancer screenings indicate that they did not consider studies based on persons with familial skin cancers. Although no recommendation is made for or against skin cancer screenings, ways in which the skin can be assessed during physical examinations performed for other reasons are identified. The importance of individual patient preference is included. The USPSTF panel is multi-disciplinary and includes [table: see text] (http://www.guideline.gov). The statement on aspirin therapy was published in the Annals of Internal Medicine and is available, along with a second article discussing the evidence in more depth (Hayden, Pignone, Phillips, & Mulrow, 2002), at: http://www.annals.org. Print versions are available through the Agency for Healthcare Research and Quality (AHRQ) Publications Clearinghouse (1-800-358-9295). Readers are encouraged to obtain full copies of the recommendations that are applicable to their practice as they become available and to assess their potential application in practice.