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Understanding How the USPSTF Works: USPSTF 101

Slide 1

 

Understanding How the
U.S. Preventive Services
Task Force Works

USPSTF 101

 

Slide 2




Goals

  • Improve understanding of the U.S. Preventive Services Task Force
    (USPSTF or Task Force)
  • Explain the connection between the USPSTF and the Agency for Healthcare Research and Quality (AHRQ)
  • Describe how the Task Force develops recommendations
  • Highlight opportunities for public input

 


 

Slide 3




Overview


The U.S. Preventive Services Task Force…
  • Makes recommendations on clinical preventive services to primary care clinicians
  • • The USPSTF scope for clinical preventive services includes:
  • Screening tests
  • • Counseling
  • • Preventive medications
  • • Recommendations address only services offered in the primary care setting or services referred by a primary care clinician.
  • • Recommendations apply to adults and children with no signs or symptoms.

 


 

 

Slide 4




Overview, continued.


The U.S. Preventive Services Task Force…
  • Makes recommendations based on rigorous review of existing peer-reviewed evidence
  • • Does not conduct the research studies, but reviews and assesses the research
  • • Evaluates benefits and harms of each service based on factors such as age and sex
  • Is an independent panel of nonfederal experts in prevention & evidence-based medicine

 


 

 

Slide 5




USPSTF Members

  • The 16 volunteer members represent disciplines of primary care including family medicine, internal medicine, nursing, obstetrics and gynecology, pediatrics, and behavioral medicine.
  • Led by a Chair and Vice Chairs.
  • Serve 4-year terms.
  • Appointed by AHRQ Director with guidance from Chair & Vice Chairs.
  • Current members include deans, medical directors, chief health officers, practicing clinicians, and professors:

 


 

 

Slide 6




AHRQ’s Support of the Task Force

  • AHRQ’s Mission: to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used.
  • AHRQ provides administrative, scientific, technical, and dissemination support to the USPSTF.
  • AHRQ’s Director, with guidance from the USPSTF Chair & Vice Chairs, appoints USPSTF members.
  • While AHRQ provides support to the USPSTF, it is important to note that the USPSTF is an independent entity.

 


 

 

Slide 7




Topic Nomination

  • How are topics nominated for review?
  • • Anyone can nominate a topic for the USPSTF to consider via its Web site
    http://www.uspreventiveservicestaskforce.org/Page/Name/nominating-recommendation-statement-topics
  • • The public may:
  • • Suggest a new preventive service topic
  • • Recommend reconsideration of an existing topic due to:
  • • Availability of new evidence
  • • Changes in the public health burden of the condition
  • • Availability of new screening tests supported by new evidence
  • • Topic nominations are accepted all year round and are considered by the
    USPSTF at its three annual meetings

 


 

 

Slide 8




Steps the USPSTF Takes to Solicit Public Input
and Make a Recommendation


Create Research Plan
Develop Evidence Review and Recommendation Statement
Disseminate Recommendation

 


 

 

Slide 9




Steps the USPSTF Takes to Solicit Public Input
and Make a Recommendation: Step 1


Create Research Plan
Draft Research Plan
Task Force members work with researchers from an Evidence-based Practice Center (EPC) to create a draft Research Plan that guides the recommendation process.
Opportunity for Public Comment
The draft Research Plan is posted on the USPSTF Web site for public comment.
Finalize Research Plan
The Task Force and EPC review all comments, address them as appropriate, and create a final Research Plan.
 
Develop Evidence Report and Recommendation Statement
 
Disseminate Recommendation

 


 

Slide 10




Steps the USPSTF Takes to Solicit Public Input and Make a Recommendation: Step 2
and Make a Recommendation: Step 3


Create Research Plan
 
Develop Evidence Review and Recommendation Statement
Draft Evidence Review
Using the final Research Plan, the research team at the EPC independently gathers and reviews the available published evidence and creates a draft Evidence Review.

–then–

Draft Recommendation Statement

The Task Force discusses the draft Evidence Review and the effectiveness of the service. Based on the discussion, the Task Force creates a draft Recommendation Statement.

Opportunity for Public Comment
The draft Evidence Review and draft Recommendation Statement are posted simultaneously on the USPSTF Web site for public comment.

–then–

Finalize Recommendation Statement

The Task Force discusses the final Evidence Review and any new evidence. The Task Force then reviews all comments on the draft Recommendation Statement, addresses them as appropriate, and creates a final Recommendation Statement.

Finalize Evidence Review
The EPC reviews all comments on the draft Evidence Review, addresses them as appropriate, and creates a final Evidence Review.
 
Disseminate Recommendation

 


 

 

Slide 11




Steps the USPSTF Takes to Solicit Public Input
and Make a Recommendation: Step 3


Create Research Plan
 
Compile Evidence Report
 
Develop Recommendation
Draft Research Plan
Task Force members discuss the Evidence Report and deliberate on the effectiveness of the service. Based on the discussion, Task Force members create a draft Recommendation.
Invite Public Comments
The draft Recommendation is posted on the USPSTF Web site for public comment. (The Evidence Report is updated and published.)
Finalize Research Plan
The Task Force reviews all comments, addresses them as appropriate, and creates a final Recommendation. Members vote to ratify the final Recommendation.
 
Disseminate Recommendation

 


 

 

Slide 12




Recommendation Grades

Letter grades are assigned to each recommendation statement. These grades are based on the strength of the evidence on the harms and benefits of a specific preventive service. http://www.uspreventiveservicestaskforce.org/Page/Name/grade-definitions
Grade Definition
A The USPSTF recommends the service. There is high certainty that the net benefit is substantial.
B The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.
C The USPSTF recommends selectively offering or providing this service to individual patients based on professional judgment and patient preferences. There is at least moderate certainty that the net benefit is small.
D The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.
I Statement The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.

 


 

Slide 13



Thank You for your interest
www.USPreventiveServicesTaskForce.org

 
Current as of: July 2014

Internet Citation: Understanding How the USPSTF Works: USPSTF 101. U.S. Preventive Services Task Force. October 2014.
http://www.uspreventiveservicestaskforce.org/Page/Name/understanding-how-the-uspstf-works

USPSTF Program Office   540 Gaither Road, Rockville, MD 20850