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U.S. Preventive Services Task Force Issues New Guidelines

The U.S. Preventive Services Task Force (USPSTF) is an independent panel first convened in 1984 to review evidence supporting preventive interventions and to issue guidelines on prevention for practicing clinicians. The first and second editions of the USPSTF's Guide to Clinical Preventive Services were published as monographs in 1989 and 1996. Now, the third USPSTF is updating its previous guidelines and creating new ones. This time, however, guidelines will be released as they are completed, and Journal Watch plans to review them as they become available.

USPSTF 3 concludes each of its guidelines with a recommendation, graded as follows:

A -- The intervention is strongly recommended.

B -- The intervention is recommended.

C -- The USPSTF makes no recommendation for or against the intervention.

D -- The intervention is not routinely recommended.

I -- Evidence is insufficient to recommend for or against the intervention.

Note the following distinction: A rating of "C" indicates that there is at least some evidence of the intervention's potential benefit but that the balance between benefit and harm is too close to merit a higher rating. In contrast, a rating of "I" indicates that the balance between benefit and harm cannot be determined because high-quality studies are lacking, or because studies yielded conflicting results.

Members of the USPSTF and authors of the reviews that inform the task force's recommendations are drawn from a variety of sources, including academic departments, government agencies, private foundations, and occasionally private industry. Analyses by the USPSTF are strongly evidence-based; thus, the USPSTF traditionally has been less likely than specialty societies and advocacy organizations to endorse preventive practices that have not been shown to improve clinical outcomes in rigorous clinical studies.

The complete text of these recommendations can be found online at http://www.ahrq.gov/clinic/uspstfix.htm and in a supplement to the April 2001 issue of the American Journal of Preventive Medicine.

— AS Brett

Published in Journal Watch General Medicine May 15, 2001