The AAFP Summary of Recommendations for Clinical Preventive Services (RCPS), formerly Summary of Recommendations for Periodic Health Examinations (RPHE), originated in the Commission on Science and was approved by the Board of Directors in March 2008. The COS and the Board of Directors decided that "clinical preventive services" would be more reflective of the recommendations and their intent.
Older revisions of the RPHE were approved by the Board in November 1996 (Rev. 1), July 1997 (Rev. 2), March 1999 (Rev. 3), July 2000 (Rev. 4), August 2001 (Rev. 5), July 2002 (Rev. 5.2), August 2002 ( Rev. 5.3), August 2003 (Rev 5.4), July 2004 (Rev 5.5), August 2004 (5.6), April 2005 (5.7), August 2005, April 2006 (Rev. 6.1), August 2006, March 2007 (Rev. 6.3), and August 2007 (Rev. 6.4).
The starting point for the recommendations is the rigorous analysis of scientific knowledge available as presented by the United States Preventive Services Task Force (USPSTF) in their Guide to Clinical Preventive Services, 2nd Edition and ongoing releases of evidence reports and recommendations from the 3rd Edition. The RCPS was developed with some consideration of overall cost and patient preferences. Costs were not specifically calculated but were estimated to include broad economic impact and opportunity costs. Patient preferences were also not explicitly stated, however the Working Group on Clinical Preventive Services, the Commission on Science, and the AAFP Board of Directors served as surrogates.
The recommendations include:
Introduction to AAFP Summary of Recommendations for Clinical Preventive Services
| SR | Strongly Recommend: Good quality evidence exists which demonstrates substantial net benefit over harm; the intervention is perceived to be cost effective and acceptable to nearly all patients. |
| R | Recommend: Although evidence exists which demonstrates net benefit, either the benefit is only moderate in magnitude or the evidence supporting a substantial benefit is only fair. The intervention is perceived to be cost effective and acceptable to most patients. |
| NR | No Recommendation Either For or Against: Either good or fair evidence exist of at least a small net benefit. Cost-effectiveness may not be known or patients may be divided about acceptability of the intervention. |
| RA | Recommend Against: Good or fair evidence which demonstrates no net benefit over harm. |
| I | Insufficient Evidence to Recommend Either for or Against: No evidence of even fair quality exists or the existing evidence is conflicting. |
| I-HB | Healthy Behavior is identified as desirable but the effectiveness of physician's advice and counseling is uncertain. |
Physicians are encouraged to review not only the needs of individual patients they see, but also of the populations in the communities they serve to determine which specific population recommendations need to be implemented systematically in their practices. The recommendations contained in this document are for screening only. They do not necessarily apply to patients who have signs and/or symptoms relating to a particular condition.
Where appropriate, specific website URL’s are provided which link directly to the clinical consideration section of the U.S. Preventive Services Task Force. The clinical consideration section provides additional information needed to interpret and implement the recommendations.
These recommendations are provided only as assistance for physicians making clinical decisions regarding the care of their patients. As such, they cannot substitute for the individual judgment brought to each clinical situation by the patient’s family physician. As with all clinical reference resources, they reflect the best understanding of the science of medicine at the time of publication, but they should be used with the clear understanding that continued research may result in new knowledge and recommendations. These recommendations are only one element in the complex process of improving the health of America. To be effective, the recommendations must be implemented.
The RCPS is available online or through the AAFP Order Department by calling 800-944-0000; ask for item number 962. The document is free.
