TY - JOUR
T1 - Current methods of the U.S. preventive services task force
T2 - A review of the process
AU - Harris, Russell P.
AU - Helfand, Mark
AU - Woolf, Steven H.
AU - Lohr, Kathleen N.
AU - Mulrow, Cynthia D.
AU - Teutsch, Steven M.
AU - Atkins, David
N1 - Funding Information:
This paper was developed by the Research Triangle Institute–University of North Carolina at Chapel Hill (RTI-UNC) and the Oregon Health Sciences University (OHSU) Evidence-Based Practice Centers under contracts from the Agency for Healthcare Research and Quality (contract nos. 290-97-0011 and 290-97-0018, respectively). We acknowledge the assistance of Jacqueline Besteman, JD, MA, EPC Program Officer; the AHRQ staff working with the third Task Force; and the staffs of the EPCs at RTI-UNC and at OHSU for their many hours of work in support of this effort. We also acknowledge the assistance of the Counseling and Behavioral Issues Work Group of the Task Force, Evelyn Whitlock, MD, MPH, convenor. Finally, we also acknowledge the major contribution of the entire third U.S. Preventive Services Task Force for its support and intellectual stimulation.
PY - 2001
Y1 - 2001
N2 - The U.S. Preventive Services Task Force (USPSTF/Task Force) represents one of several efforts to take a more evidence-based approach to the development of clinical practice guidelines. As methods have matured for assembling and reviewing evidence and for translating evidence into guidelines, so too have the methods of the USPSTF. This paper summarizes the current methods of the third USPSTF, supported by the Agency for Healthcare Research and Quality (AHRQ) and two of the AHRQ Evidence-based Practice Centers (EPCs) The Task Force limits the topics it reviews to those conditions that cause a large burden of suffering to society and that also have available a potentially effective preventive service. It focuses its reviews on the questions and evidence most critical to making a recommendation. It uses analytic frameworks to specify the linkages and key questions connecting the preventive service with health outcomes. These linkages, together with explicit inclusion criteria, guide the literature searches for admissible evidence Once assembled, admissible evidence is reviewed at three strata: (1) the individual study, (2) the body of evidence concerning a single linkage in the analytic framework, and (3) the body of evidence concerning the entire preventive service. For each stratum, the Task Force uses explicit criteria as general guidelines to assign one of three grades of evidence: good, fair, or poor. Good or fair quality evidence for the entire preventive service must include studies of sufficient design and quality to provide an unbroken chain of evidence-supported linkages, generalizable to the general primary care population, that connect the preventive service with health outcomes. Poor evidence contains a formidable break in the evidence chain such that the connection between the preventive service and health outcomes is uncertain. For services supported by overall good or fair evidence, the Task Force uses outcomes tables to help categorize the magnitude of benefits, harms, and net benefit from implementation of the preventive service into one of four categories: substantial, moderate, small, or zero/negative. The Task Force uses its assessment of the evidence and magnitude of net benefit to make a recommendation, coded as a letter: from A (strongly recommended) to D (recommend against). It gives an I recommendation in situations in which the evidence is insufficient to determine net benefit. The third Task Force and the EPCs will continue to examine a variety of methodologic issues and document work group progress in future communications.
AB - The U.S. Preventive Services Task Force (USPSTF/Task Force) represents one of several efforts to take a more evidence-based approach to the development of clinical practice guidelines. As methods have matured for assembling and reviewing evidence and for translating evidence into guidelines, so too have the methods of the USPSTF. This paper summarizes the current methods of the third USPSTF, supported by the Agency for Healthcare Research and Quality (AHRQ) and two of the AHRQ Evidence-based Practice Centers (EPCs) The Task Force limits the topics it reviews to those conditions that cause a large burden of suffering to society and that also have available a potentially effective preventive service. It focuses its reviews on the questions and evidence most critical to making a recommendation. It uses analytic frameworks to specify the linkages and key questions connecting the preventive service with health outcomes. These linkages, together with explicit inclusion criteria, guide the literature searches for admissible evidence Once assembled, admissible evidence is reviewed at three strata: (1) the individual study, (2) the body of evidence concerning a single linkage in the analytic framework, and (3) the body of evidence concerning the entire preventive service. For each stratum, the Task Force uses explicit criteria as general guidelines to assign one of three grades of evidence: good, fair, or poor. Good or fair quality evidence for the entire preventive service must include studies of sufficient design and quality to provide an unbroken chain of evidence-supported linkages, generalizable to the general primary care population, that connect the preventive service with health outcomes. Poor evidence contains a formidable break in the evidence chain such that the connection between the preventive service and health outcomes is uncertain. For services supported by overall good or fair evidence, the Task Force uses outcomes tables to help categorize the magnitude of benefits, harms, and net benefit from implementation of the preventive service into one of four categories: substantial, moderate, small, or zero/negative. The Task Force uses its assessment of the evidence and magnitude of net benefit to make a recommendation, coded as a letter: from A (strongly recommended) to D (recommend against). It gives an I recommendation in situations in which the evidence is insufficient to determine net benefit. The third Task Force and the EPCs will continue to examine a variety of methodologic issues and document work group progress in future communications.
KW - Evidence-based medicines
KW - MEDLINE
KW - Methods
KW - Practice guidelines
KW - Preventive health services
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U2 - 10.1016/S0749-3797(01)00261-6
DO - 10.1016/S0749-3797(01)00261-6
M3 - Article
C2 - 11306229
AN - SCOPUS:0035318124
SN - 0749-3797
VL - 20
SP - 21
EP - 35
JO - American journal of preventive medicine
JF - American journal of preventive medicine
IS - 3 SUPPL.
ER -