The U.S. Preventive Services Task Force (USP-STF) is back. Following in the steps of its predecessors, which produced similar evidence reports in 1989 and 1995, the third USPSTF (convened by the Agency for Healthcare Research and Quality [AHRQ] in 1998) systematically reviews the evidence on the effectiveness of clinical preventive services in primary care, including screening, counseling, and chemoprevention.
However, in other respects this Task Force differs from its predecessors. The systematic evidence reviews that support Task Force recommendations are now conducted by two AHRQ-supported Evidence-based Practice Centers (EPCs), one at Oregon Health Sciences University, Portland, and the other at Research Triangle Institute, Research Triangle Park, N.C. In preparing the reviews, the EPCs conduct a comprehensive analysis of the research literature using state-of-the-art standards of evidence, and solicit input from a number of federal and private reviewers.
The USPSTF uses the reviews and comments, but guards its independence by separating the evidence review from the crafting of recommendations. Final recommendations are based on the quality of the evidence and the relative balance of benefits and harms. The expertise of the Task Force is broader than it has been in the past, with members representing family medicine, pediatrics, internal medicine, obstetrics and gynecology, geriatrics, preventive medicine, public health, behavioral medicine, and nursing. The Task Force has chosen to release its recommendations in print and on the Web (http://www.ahrq.gov/clinic/uspstfix.htm) as they are completed, rather than waiting until the conclusion of all its work to release a single volume.
AHRQ and American Family Physician are working together to publish the recommendations of the new USPSTF. Although Task Force recommendations will appear first in other journals or on the AHRQ Web site, AFP will publish most, if not all, Task Force reports and recommendations in its print version and will feature all on its Web site in full-text format.
The Task Force recommendation that appears in this issue is based on a review of the evidence on the effectiveness of routine screening of newborns for hearing loss. Soon, AFP will publish previously released Task Force recommendations on screening for lipid disorders, chlamydial infection, bacterial vaginosis in pregnancy, and skin cancer. Other new recommendations, on such topics as the role of aspirin in the primary prevention of cardiovascular events, screening for depression in primary care, breast cancer chemoprevention, colorectal cancer screening, and hormone replacement therapy, will appear in AFP in the coming year.
The Task Force has helped to establish the importance of prevention in primary health care, ensuring medical insurance coverage for preventive services and holding clinicians and health care systems accountable for delivering effective care. Its recommendations highlight opportunities for improved delivery of effective health care services and have helped to narrow gaps in the provision of preventive care in different populations.
We are pleased to launch AFP's publication of the new USPSTF recommendations and look forward to bringing you the complete set in the months and years to come.