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Understanding How the USPSTF Works: USPSTF 101


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Understanding How the U.S. Preventive Services Task Force Works: USPSTF 101

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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. Highlight dissemination efforts.

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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 (or unrecognized signs and symptoms).

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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 non-Federal experts in prevention & evidenced-based medicine.

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USPSTF Members: The 16 volunteer members represent disciplines of primary care including family medicine, internal medicine, nursing, obstetrics/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. Complete a rigorous review of potential conflicts of interest. Current members include deans, medical directors, practicing clinicians, and professors: http://www.uspreventiveservicestaskforce.org/members.htm.

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AHRQ's Support of the Task Force. AHRQ provides administrative, scientific, technical, and dissemination support to the USPSTF.  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. While AHRQ provides support to the USPSTF, it is important to note that the USPSTF is an independent entity.

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USPSTF Recommendation Development Process. Rigorous 4-stage recommendation development process: Topic nomination, Draft and final research plans, Draft evidence review and recommendation statement, Final evidence review and recommendation statements. 4-week public comment period on all drafts. Consult with subject matter experts. Procedure manual available under Methods and Processes at: http://www.uspreventiveservicestaskforce.org.

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The USPSTF Recommendations Development Process. Step 1: Topic Nomination.

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The USPSTF Recommendations Development Process, continued. Step 2: Draft and Final Research Plans.

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The USPSTF Recommendations Development Process, continued. Step 3: Draft Evidence Review and Draft Recommendation Statement.

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The USPSTF Recommendations Development Process, continued. Step 4: Final Evidence Review and Final Recommendation Statement.

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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/uspstf/grades.htm. Grade A: The USPSTF recommends the service. There is high certainty that the net benefit is substantial. Grade 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. Grade 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. Grade 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.

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USPSTF Partners. USPSTF Partners provide input on recommendations and facilitate dissemination and implementation. Partners represent: Primary care clinicians, consumers, and other stakeholders, Federal agencies. Partners help the Task Force ensure that its recommendations are useful for clinicians and able to be put into practice. Partners also support the Task Force as they work to keep America's primary care workforce up to date on USPSTF recommendations.

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USPSTF Partners list.

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Public Engagement With USPSTF. The Task Force is committed to transparency and public engagement. Several opportunities for the public to provide input: Task Force member nomination, Topic nomination, Public comment periods during draft stages. USPSTF email list helps the public stay up-to-date on Task Force activities, including public comment periods. Individuals and organizations can provide comments and sign up for the email list by visiting the Task Force’s Web site: www.uspreventiveservicestaskforce.org.

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USPSTF Dissemination Efforts. Some activities the Task Force conducts to disseminate its recommendations include: Electronic Preventive Services Selector (ePSS) (http://epss.ahrq.gov), a Web site and mobile app that allows clinicians to identify which preventive services are right for their patients. Healthfinder Web site (http://healthfinder.gov) a tool for patients to learn more about prevention and find the right preventive services for them. Email list notifications to alert subscribers to topic activity as well as general Task Force updates. News bulletins to summarize recommendations for the media. Plain language summaries of Task Force draft recommendations to help individuals understand the recommendation before submitting comments.

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USPSTF Dissemination Efforts, continued. The Task Force also has a partnership with JAMA to publish final recommendation statements and evidence summaries, reaching a wide network of clinicians and the public. JAMA develops materials including a patient page and audio podcast to help explain recommendations. Beyond final recommendations, the Task Force: Develops a yearly Report to Congress to highlight evidence gaps and guide future research. Publishes editorials in peer-reviewed journals about different areas of interest in prevention and evidence-based medicine.

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Thank You for your interest. www.USPreventiveServicesTaskForce.org.

Current as of: October 2016

Internet Citation: Understanding How the USPSTF Works: USPSTF 101. U.S. Preventive Services Task Force. October 2016.
https://www.uspreventiveservicestaskforce.org/Page/Name/understanding-how-the-uspstf-works

USPSTF Program Office   5600 Fishers Lane, Mail Stop 06E53A, Rockville, MD 20857