You Are Here:
- Tell me more about the U.S. Preventive Services Task Force (USPSTF).
- Tell me more about clinical preventive services.
- Tell me more about the USPSTF Recommendation Statements and how they are used.
- Tell me how the Agency for Healthcare Research and Quality supports the USPSTF.
- Tell me more about the role of Evidence-Based Practice Centers in developing USPSTF Recommendations.
- Tell me where I can find topics that have been or are being developed into USPSTF Recommendations.
- Tell me who serves on the USPSTF and how they are selected.
- Tell me how to comment on draft USPSTF Recommendations.
Anyone — including individuals and organizations — can nominate a topic for the U.S. Preventive Services Task Force (USPSTF) to consider for evaluation for a future recommendation. To nominate a topic:
- Read the information below about the USPSTF and how it chooses topics for its recommendations.
- Complete one of the Topic Nomination Forms below.
The USPSTF is a Congressionally mandated, independent panel of medical experts in primary care and prevention composed of primary care providers—internists, pediatricians, family physicians, gynecologists/obstetricians, nurses, and health behavior specialists—who are charged with making recommendations to primary care providers about clinical preventive services.
The USPSTF Recommendations
The USPSTF rigorously evaluates clinical research to assess the benefits and harms of various preventive interventions (for example, screening for high blood pressure or colorectal cancer). The results of these evaluations are published as USPSTF Recommendation Statements on the USPSTF Web site (http://www.uspreventiveservicestaskforce.org/) and in various peer-reviewed medical journals.
USPSTF recommendations are intended to improve clinical practice and promote the health of the American public. The recommendations are on preventive services for asymptomatic people—people without signs or symptoms of the conditions targeted by the preventive service. The recommendations are meant to prevent the onset, spread of, or complications of disease. The USPSTF makes recommendations about three types of clinical preventive services:
- Screening tests, such as screening for colorectal cancer and blood pressure or cholesterol measurement.
- Preventive medications, such as aspirin for preventing stroke or heart disease.
- Counseling about healthy behaviors, such as quitting smoking, eating a healthy diet, or staying active.
The USPSTF reviews the evidence for a preventive service to determine its effectiveness, measured by the balance of benefits and harms—for specific groups based on age, sex, and other risk factors for the condition being addressed. For the USPSTF to consider a preventive service effective, benefits must outweigh the harms, or burdens experienced as a result of the service. The USPSTF looks at several different types of harms, including direct harms (such as harms from invasive procedures), and harms from follow-up testing or treatments. The USPSTF also considers excessive time or effort needed on the part of the patient or the health care provider to be a harm. The USPSTF does not evaluate the cost-effectiveness of preventive services.
After deliberation, the USPSTF assigns one of five letter ratings to its recommendations: A, B, C, D or I. For details about what the ratings indicate, go to http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm.
The goals in selecting topics for USPSTF Recommendations are:
- To provide accurate and relevant recommendations that are as up-to-date as possible.
- To balance the overall portfolio of USPSTF recommendations by populations (for example, newborns, children, adults and older adults), types of services (screening, preventive medications, and counseling), and disease types.
Development of a Recommendation Statement from a newly nominated topic takes approximately 2-to-3 years. In past years, the USPSTF generally has selected one or two new topics a year for which to evaluate the evidence and develop a recommendation.
The USPSTF first considers whether a nominated topic is within the scope of the USPSTF, meaning that the topic:
- Relates to a preventive service that is meant to a) avoid the development of disease (primary prevention) or b) identify and treat an existing disease before it results in significant symptoms (secondary prevention);
- Is relevant to primary care; and
- Addresses a disease with a substantial health burden.
Topics that meet these criteria are prioritized according to:
- Public health importance (that is, burden of suffering and expected effectiveness of the preventive service to reduce that burden); and
- Potential for a recommendation to affect clinical practice (that is, it resolves a controversy or closes a gap between evidence and practice).
Full details of how the USPSTF chooses topics and develops recommendations from them are available in the USPSTF Procedure Manual at http://www.uspreventiveservicestaskforce.org/uspstf08/methods/procmanual2.htm
Topic Nomination for USPSTF Recommendations
A topic nomination may:
- Suggest a new preventive service topic, supported by evidence that has been published in a peer-reviewed journal. The topic should be one that has not been reviewed by the USPSTF to date.
- Recommend reconsideration of an existing topic. Occasionally the USPSTF may reconsider a recommendation, including its grade or its scope, before the USPSTF's standard 5-year cycle of review has passed. Reconsideration may stem from research published after a recommendation's release, such as research on new populations or age groups or research that links the preventive service more directly to the targeted condition's health effect. Changes, such as a change in the public health burden of a condition or new screening tests, also may prompt the USPSTF to reconsider a recommendation. The USPSTF does not consider cost effectiveness studies when deciding to reconsider a recommendation.
Nominations for new topics or reconsiderations are accepted at any time and are considered by the USPSTF at one of its regularly scheduled meetings in March, July, or November.
You may nominate a new topic or recommend reconsideration of an existing topic by selecting one of the topic nomination forms listed below:
Please select the New Topic Form to nominate new topics.
Please select the Topic Reconsideration Form to suggest updates or changes in scope for existing recommendations.
Please submit a separate form for each topic.
Current as of February 2011
Nominate a Recommendation Statement Topic. U.S. Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/tftopicnom.htm