Overview of AAFP Clinical Preventive Services Recommendations

The AAFP Clinical Preventive Services recommendations are developed through the AAFP’s Commission on Health of the Public and Science (CHPS) and are approved by the AAFP Board of Directors. The AAFP has a long-standing partnership with the United States Preventive Services Task Force (USPSTF) and participates in all steps in the development of the preventive services recommendations which includes:

• Nomination of qualified family physicians to serve on the USPSTF
• Nomination of topics for evidence reviews and potential recommendations
• Public comment on draft recommendations and evidence reports
• Review of final recommendations

The AAFP Clinical Preventive Services Recommendations are based on the rigorous analysis of scientific research performed by the United States Preventive Services Task Force (USPSTF). The USPSTF conducts impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening, counseling, and preventive medications.

CHPS reviews all USPSTF recommendations and evidence reports and determines whether the AAFP should agree with the recommendation or develop a separate AAFP recommendation based on the evidence. If there is agreement with the USPSTF, members are referred to the USPSTF website for more information. If a new recommendation is developed, it is published on the AAFP website and disseminated to members. AAFP Clinical Preventive Services Recommendations use a grading system consistent with the USPSTF and described below.

The recommendations contained in this document are for screening, chemoprophylaxis and counseling only.  They do not necessarily apply to patients who have signs and/or symptoms relating to a particular condition. 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.

AAFP Clinical Preventive Services Recommendations Grading System

A     Recommendation: The AAFP recommends the service. There is high certainty that the net benefit is substantial.

B     Recommendation:  The AAFP 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.

C    Recommendation:  The AAFP 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.

D   Recommendation: The AAFP 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     Recommendation:  The AAFP 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.  

I-HB    Healthy Behavior is identified as desirable but the effectiveness of physician’s advice and counseling is uncertain.