First Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services - III
Table of Contents
- Executive Summary
- I. Introduction
- II. Background
- III. Role of USPSTF in Clinical Prevention
- IV. Major Activities of the USPSTF in 2010–2011
- V. Current Evidence Gaps Deserving of Further Research
- High-Priority Evidence Gaps for Screening Tests
- High-Priority Evidence Gaps for Behavioral Interventions
- High-Priority Evidence Gaps in Clinical Preventive Services Targeting Specific Populations and Age Groups
- VI. Next Steps for the USPSTF in 2012
- Appendix A. 2011 Members of the USPSTF
- Appendix B. USPSTF Partner Organizations
- Appendix C. Complete Listing of All USPSTF Specific Recommendations as of September 2011
III. Role of USPSTF in Clinical Prevention
Dissemination of USPSTF Recommendations
The current USPSTF library includes over 100 preventive services topics with over 140 specific recommendations (topics can encompass multiple specific recommendations). Numerous methods, including publication in peer-reviewed medical journals, are utilized to help primary care clinicians and other audiences become more aware of and use the recommendations.
The full USPSTF library of recommendations, including evidence reports and other supporting materials, is available at www.uspreventiveservicestaskforce.org. Through this Web site, the USPSTF reaches hundreds of thousands of visitors each month. Between August 2010 and May 2011, the USPSTF Web site received over 1.5 million unique visits, resulting in over 9.8 million page views and more than 530,000 file downloads.
AHRQ publishes the Guide to Clinical Preventive Services, a free, pocket-sized book that is a compilation of current USPSTF recommendations in abridged form. It has been distributed widely through high-value dissemination efforts with other federal agencies and USPSTF partners.
Task Force recommendations are also available in an easy-to-use electronic tool, the electronic Preventive Services Selector (ePSS). ePSS can be searched by specific patient characteristics, such as age, sex, and selected behavioral risk factors, to produce a list of recommendations that is individualized for the patient. It is available both as a Web-based tool and as a downloadable application for a variety of smartphones and other devices, such as tablet computers, and brings USPSTF recommendations, clinical considerations, and selected practice tools to the point of care. In 2010, over 31,000 individuals downloaded ePSS to a mobile device, and the Web-based version of the tool had over 200,000 visitors. ePSS is also available as a "widget," a stand-alone application that can be embedded into any Web page.
by Amit Patel, M.D., May 9, 2011
AHRQ ePSS's information is based on the U.S. Preventive Services Task Force (USPSTF) recommendations, and has proven itself as a useful tool in my continuity clinic, where preventive care plays an important part.
Especially at the outset of my training, AHRQ ePSS allowed me to input a patient's age and other demographic variables, generating the USPSTF-appropriate screening and counseling guidelines for the patient. Moreover, this app offers links to a handful of useful tools (including various screening instruments and patient brochures). In summary, AHRQ ePSS is a very useful tool for the primary care clinic setting, especially for screening, counseling, and preventive care.
Major Implementation Initiatives
As part of its support of the Task Force, AHRQ has partnered with the Department of Health and Human Services, Office of Disease Prevention and Health Promotion to translate USPSTF recommendations with grades of "A" or "B" (services for which the benefits outweigh the harms) for members of the public. Consumers can go to the Personal Health Tool on the www.Healthfinder.gov Web site to get a list of USPSTF-recommended services based on their age and sex.
Over time, State governments, individual practices, clinics, and hospitals have begun to integrate USPSTF tools and resources into practice in new and innovative ways.
The Guide to Clinical Preventive Services and ePSS are also used in a variety of educational settings to improve the preventive medicine training received by future primary care and public health providers.
Piedmont Healthcare, a large integrated health system in the Atlanta area, has successfully embedded ePSS into its electronic health record (EHR) system. The integration of ePSS into EHRs allows individualized USPSTF recommendations to be directly available to clinicians every time a patient comes for a visit. This new system also shows providers the date a patient received a preventive service, the results, and, if applicable, past medical history. Staff members working directly with the patients are trained to access the patient's medical record at the beginning of the visit and complete a summary of the patient's health profile. Providers are then informed whether the patient needs a referral for a test, such as colorectal screening, or counseling, such as smoking cessation support. Piedmont Healthcare is one of several examples of the seamless integration of ePSS into clinical care.
At the University of North Texas Health Science Center in Fort Worth, an education and training program for physician assistants is using the Guide as a tool for student research on clinical preventive services. Previous editions of the Guide have also been widely used in undergraduate and postgraduate medical and nursing education as a key reference for teaching preventive care.
At the Colorado Area Health Education Center, preceptors and medical students are instructed to use the ePSS tool for all preventive clinical service patients they see during their 8-week family practice rotation. The University of Washington Medical School has developed a similar program for medical students enrolled in clinical rotations so that they can easily identify appropriate preventive services for their patients.
Internet Citation: First Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services - III. U.S. Preventive Services Task Force. December 2013.