Guideline Title
Summary of recommendations for clinical preventive services.
Bibliographic Source(s)
American Academy of Family Physicians (AAFP). Summary of recommendations for clinical preventive services. Leawood (KS): American Academy of Family Physicians (AAFP); 2010 Jan. 17 p.
Guideline Status
This is the current release of the guideline.
This guideline updates a previous version: American Academy of Family Physicians (AAFP). Summary of recommendations for clinical preventive services. Revision 6.8. Leawood (KS): American Academy of Family Physicians (AAFP); 2009 Apr. 15 p.
Clinical Preventive Services, Including Screening, Counseling, and Immunization
Screening specified populations for abdominal aortic aneurysm
Screening and counseling specified populations regarding alcohol misuse
Screening specified population for asymptomatic bacteriuria
Screening for bacterial vaginosis in pregnant women
Behavioral counseling to prevent sexually transmitted infections (STIs)
Screening for bladder cancer in adults
Screening specified women by age group for breast cancer with mammography
Teaching routine breast self-examination (BSE)
Screening for breast cancer with clinical breast examination
Screening for breast cancer with digital mammography or magnetic resonance imaging (MRI)
Referring specified female population for genetic counseling and evaluation for breast cancer susceptibility gene (BRCA) testing
Counseling parents of infants regarding breastfeeding
Using aspirin in specified populations to prevent cardiovascular disease
Screening general adult population for asymptomatic carotid artery stenosis (CAS)
Screening women for cervical cancer with new technologies, human papillomavirus testing, and Pap smear
Screening specified populations for chlamydia
Screening specified populations for colorectal cancer using fecal occult blood testing, sigmoidoscopy, colonoscopy, computed tomography colonography, or fecal DNA testing
Counseling on use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) to prevent colorectal cancer in average risk individuals
Screening newborns for congenital hypothyroidism (CH)
Screening for coronary heart disease with electrocardiography, exercise treadmill test, or electron-beam computerized tomography
Providing fluoride supplementation to prevent dental caries in specified populations
Screening for depression in specified population
Screening specified populations for type 2 diabetes
Screening infants for dysplasia of the hip
Screening for family violence and intimate partner violence
Screening for genital herpes simplex virus infection
Screening for gestational diabetes
Screening for glaucoma
Ordering ocular prophylaxis for gonococcal infection in neonates
Screening for gonorrhea in specified populations
Behavioral dietary counseling for specified populations
Screening and counseling specified population regarding hearing difficulties
Screening newborns for hearing loss sensorineural (SNHL)
Screening for hereditary hemochromatosis
Screening neonates for hemoglobinopathies, phenylketonuria (PKU), and thyroid function abnormalities
Screening specified populations for hepatitis B virus (HBV)
Screening specified populations for hepatitis C virus (HCV)
Screening specified populations for human immunodeficiency virus (HIV) infection
Hormone replacement therapy in postmenopausal women
Screening for hypertension
Screening specified populations for illicit drug use
Immunizing identified populations according to American Academy of Family Physicians (AAFP) recommendations
Screening specified populations for iron deficiency anemia
Screening specified populations for lead poisoning
Screening specified populations for lipid disorders
Screening for lung cancer with x-ray and/or sputum cytology
Folic acid supplementation in specified female population to prevent neural tube defects
Screening, counseling, and behavioral interventions for obesity
Screening for oral cancer
Screening specified populations for osteoporosis
Screening for ovarian cancer
Referral for genetic counseling and BRCA testing in specified populations
Screening for pancreatic cancer using abdominal palpation, ultrasound, or serological markers
Screening for peripheral arterial disease (PAD)
Screening neonates for PKU
Counseling individuals regarding importance of physical activity
Screening for prostate cancer
Screening for chronic obstructive pulmonary disease (COPD) using spirometry
Rh (D) blood typing and antibody testing for pregnant women
Screening for idiopathic scoliosis in adolescents
Behavioral counseling to prevent STIs in specified populations
Screening newborns for sickle cell disease
Screening for skin cancer
Screening for speech and language delay in preschool children
Screening specified populations for syphilis
Screening for testicular cancer
Screening for thyroid cancer using ultrasound
Screening for thyroid disease
Screening neonates for thyroid function abnormalities
Screening specified populations for tobacco use and providing smoking cessation counseling
Screening specified individuals for tuberculosis using the Mantoux test
Screening specified populations for visual difficulties and impairment
Vitamin supplementation (A, C, E, beta-carotene; multivitamins with folic acid; or antioxidant combinations) for prevention of cancer or cardiovascular disease
Summary of Recommendations for Clinical Preventive Services
► Abdominal Aortic Aneurysm
* The AAFP recommends one-time screening for abdominal aortic aneurysm (AAA) by ultrasonography in men aged 65 to 75 years who have ever smoked. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsaneu.htm )
* The AAFP makes no recommendation for or against screening for AAA in men aged 65 to 75 years who have never smoked. (Grade: C recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsaneu.htm )
* The AAFP recommends against routine screening for AAA in women. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsaneu.htm )
► Alcohol Misuse
* The AAFP recommends screening and behavioral counseling interventions to reduce alcohol misuse by adults, including pregnant women, in primary care settings. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: www.ahrq.gov/clinic/uspstf/uspsdrin.htm )
* The AAFP recognizes avoidance of alcohol products by adolescents is desirable. The effectiveness of physician's advice and counseling in this area is uncertain. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsdrin.htm )
► Bacteriuria, Asymptomatic
* The AAFP recommends screening for asymptomatic bacteriuria with urine culture for pregnant women at 12 to 16 weeks' gestation or at the first prenatal visit, if later. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbact.htm )
* The AAFP recommends against screening for asymptomatic bacteriuria in men and nonpregnant women. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbact.htm )
► Bacterial Vaginosis
The AAFP recommends against screening for bacterial vaginosis in asymptomatic pregnant women at low risk for preterm delivery. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbvag.htm )
* The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for bacterial vaginosis in asymptomatic pregnant women at high risk for preterm delivery. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbvag.htm )
► Behavioral Counseling to Prevent Sexually Transmitted Infections (STIs)
* The AAFP recommends high-intensity behavioral counseling to prevent STIs for all sexually active adolescents and for adults at increased risk for STIs. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsstds.htm )
* The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of behavioral counseling to prevent STIs in non-sexually active adolescents and in adults not at increased risk for STIs. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsstds.htm )
► Bladder Cancer
The AAFP recommends against routine screening for bladder cancer in adults. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsblad.htm )
► Breast Cancer
** Family physicians should discuss with each woman the potential benefits and harms of breast cancer screening tests and develop a plan for early detection of breast cancer that minimizes potential harms. These discussions should include the evidence regarding each screening test, the risk of breast cancer, and individual patient preferences. The recommendations below are based on current best evidence as summarized by the U.S. Preventive Services Task Force (USPSTF) and can help to guide physicians and patients. These recommendations are intended to apply to women who are not at increased risk of developing breast cancer and only apply to routine screening procedures.
* The AAFP recommends that the decision to conduct screening mammography before age 50 should be individualized and take into account patient context including her risks as well as her values regarding specific benefits and harms. (January 2010) (Grade: C Recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.ahrq.gov/clinic/uspstf09/breastcancer/brcanrs.htm#clinical )
* The AAFP recommends biennial (every two years) screening mammography for women between ages 50 and 74. (January 2010) (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm )
* The AAFP concludes that the current evidence is insufficient to assess the benefits and harms of screening mammography in women aged 75 years and older. (January 2010) (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm )
* The AAFP recommends against clinicians teaching women breast self examination (BSE). (January 2010) (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm )
* The AAFP concludes that the current evidence is insufficient to assess the benefits and harms of clinical breast examination (CBE) for women aged 40 years and older. (January 2010) (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm )
* The AAFP concludes that current evidence is insufficient to assess benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film screen mammography as screening modalities for breast cancer. (January 2010) (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm )
* The AAFP recommends that women whose family history is associated with an increased risk for deleterious mutations in breast cancer susceptibility gene BRCA1 or BRCA2 be referred for genetic counseling and evaluation for BRCA testing. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrgen.htm )
* The AAFP recommends against routine referral for genetic counseling or routine BRCA testing for women whose family history is not associated with increased risk for deleterious mutations in BRCA1 or BRCA2. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrgen.htm )
► Breastfeeding
* The AAFP recommends interventions during pregnancy and after birth to promote and support breastfeeding. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrfd.htm ) (For Definition of Interventions: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post )
► Cardiovascular Disease
* The AAFP recommends the use of aspirin for men age 45 to 79 years when the potential benefit due to a reduction in myocardial infarctions outweighs the potential harm due to an increase in gastrointestinal hemorrhage. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsasmi.htm )
* The AAFP recommends the use of aspirin for women age 55 to 79 years when the potential benefit of a reduction in ischemic strokes outweighs the potential harm of an increase in gastrointestinal hemorrhage. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsasmi.htm )
* The AAFP recommends against the use of aspirin for stroke prevention in women younger than 55 years and for myocardial infarction prevention in men younger than 45 years. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsasmi.htm )
* The AAFP concludes that the evidence is insufficient to assess the benefits and harms of aspirin for cardiovascular disease prevention in men and women 80 years or older. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsasmi.htm )
► Carotid Artery Stenosis
* The AAFP recommends against screening for asymptomatic carotid artery stenosis (CAS) in general adult populations. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsacas.htm )
► Cervical Cancer
* The AAFP concludes that there is insufficient evidence to recommend for or against routine use of new technologies to screen for cervical cancer. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm )
* The AAFP concludes that there is insufficient evidence to recommend for or against routine use of human papillomavirus (HPV) testing as a primary screening test for cervical cancer. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm )
* The AAFP strongly recommends that a Pap smear be completed at least every 3 years to screen for cervical cancer for women who have ever had sex and have a cervix. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm )
► Chlamydia
* The AAFP recommends screening for chlamydial infection for all sexually active non-pregnant young women aged 24 and younger and for older non-pregnant women who are at increased risk. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschlm.htm )
* The AAFP recommends screening for chlamydial infection for all pregnant women aged 24 and younger and for older pregnant women who are at increased risk. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschlm.htm )
* The AAFP recommends against routinely providing screening for chlamydial infection for women aged 25 and older whether or not they are pregnant, if they are not at increased risk. (Grade: C recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschlm.htm )
* The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for chlamydial infection for men. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschlm.htm )
► Colorectal Cancer
* The AAFP recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy, in adults, beginning at age 50 years and continuing until age 75 years. The risk and benefits of these screening methods vary. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Go to Rationale and Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm )
* The AAFP recommends against routine screening for colorectal cancer in adults age 76 to 85 years. There may be considerations that support colorectal cancer screening in an individual patient. (Grade: C recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Go to Rationale and Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm )
* The AAFP recommends against screening for colorectal cancer in adults older than age 85 years. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Go to Rationale and Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm )
* The AAFP recommends against the routine use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) to prevent colorectal cancer in individuals at average risk for colorectal cancer. (Grade: C recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsasco.htm )
* The AAFP concludes that the evidence is insufficient to assess the benefits and harms of computed tomographic colonography and fecal deoxyribonucleic acid (DNA) testing as screening modalities for colorectal cancer. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm )
► Congenital Hypothyroidism
The AAFP recommends screening for congenital hypothyroidism (CH) in newborns. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspscghy.htm )
► Coronary Heart Disease
* The AAFP recommends against routine screening with resting electrocardiography (ECG), exercise treadmill test (ETT), or electron-beam computerized tomography (EBCT) scanning for coronary calcium for either the presence of severe coronary artery stenosis (CAS) or the prediction of coronary heart disease (CHD) events in adults at low risk for CHD events. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsacad.htm )
* The AAFP found insufficient evidence to recommend for or against routine screening with ECG, ETT, or EBCT scanning for coronary calcium for either the presence of severe CAS or the prediction of CHD events in adults at increased risk for CHD events. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsacad.htm )
► Dental Caries
The AAFP strongly recommends ordering fluoride supplementation to prevent dental caries based on age and fluoride concentration of patient's water supply for infants and children age 6 months through 16 years residing in areas with inadequate fluoride in the water supply (less than 0.6 ppm).
► Depression
* The AAFP recommends screening adults for depression. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsdepr.htm )
* The AAFP recommends screening of adolescents (12 to 18 years of age) for major depressive disorder (MDD) when systems are in place to ensure accurate diagnosis, psychotherapy (cognitive-behavioral or interpersonal), and follow-up. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschdepr.htm )
* The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening of children (7 to 11 years of age). (Grade: I statement) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschdepr.htm )
► Diabetes
* The AAFP recommends screening for type 2 diabetes in asymptomatic adults with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsdiab.htm )
* The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for type 2 diabetes in asymptomatic adults with blood pressure of 135/80 mm Hg or lower. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsdiab.htm )
► Dysplasia (Developmental) of the Hip
* The AAFP concludes that the evidence is insufficient to recommend routine screening for developmental dysplasia of the hip in infants as a means to prevent adverse outcomes. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspshipd.htm )
► Family Violence and Intimate Partner Violence
* The AAFP recognizes that all family physicians should be alert to physical and behavioral signs and symptoms associated with abuse or neglect. The AAFP concludes that the evidence is insufficient to recommend for or against screening of parents or guardians for the physical abuse or neglect of children, of adults or adolescents of either sex for intimate partner violence, or of older adults or their caregivers for elder abuse. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsfamv.htm )
► Genital Herpes Simplex Virus (HSV) Infection
* The AAFP recommends against routine serological screening for HSV in asymptomatic pregnant women at any time during pregnancy to prevent neonatal HSV infection. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsherp.htm )
* The AAFP recommends against routine serological screening for HSV in asymptomatic adolescents and adults. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsherp.htm )
► Gestational Diabetes
* The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for gestational diabetes mellitus (GDM), either before or after 24 weeks' gestation. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsgdm.htm )
►► Glaucoma
* The AAFP found insufficient evidence to recommend for or against screening adults for glaucoma. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsglau.htm )
► Gonococcal Infection in Neonates
* The AAFP strongly recommends prophylactic ocular topical medication for all newborns against gonococcal ophthalmia neonatorum. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsgono.htm )
► Gonorrhea
* The AAFP recommends that clinicians screen all sexually active women, including those who are pregnant, for gonorrhea infection if they are at increased risk for infection (that is, if they are young or have other individual or population risk factors); see clinical consideration for further discussion of risk factors. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsgono.htm )
* The AAFP concludes there is insufficient evidence to recommend for or against screening for gonorrhea infection in pregnant women who are not at increased risk for infection; see clinical consideration for further discussion of risk factors. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsgono.htm )
* The AAFP concludes there is insufficient evidence to recommend for or against routine screening for gonorrhea infection in men at increased risk for infection; see clinical consideration for further discussion of risk factors. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsgono.htm )
* The AAFP recommends against routine screening for gonorrhea infection in men and women who are at low risk for infection; see clinical consideration for further discussion of risk factors. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsgono.htm )
► Healthy Diet
* The AAFP recommends intensive behavioral dietary counseling for adult patients with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease. Intensive counseling can be delivered by primary care physicians or by other qualified professionals including dietitians and nutritionists. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsdiet.htm )
► Hearing Difficulties
* The AAFP recommends screening for hearing difficulties by questioning elderly adults about hearing impairment and counsel regarding the availability of treatment when appropriate. (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspshear.htm )
► Hearing Loss Sensorineural (SNHL)
* The AAFP recommends screening for hearing loss in all newborn infants. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsnbhr.htm )
► Hemochromatosis
* The AAFP recommends against routine genetic screening for hereditary hemochromatosis in the asymptomatic general population. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspshemoch.htm )
► Hemoglobinopathies
* The AAFP strongly recommends ordering screening tests for phenylketonuria (PKU), hemoglobinopathies, and thyroid function abnormalities in neonates. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspshemo.htm )
► Hepatitis B Virus (HBV) Infection
* The AAFP recommends screening for HBV in pregnant women at their first prenatal visit. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspshepbpg.htm )
► Hepatitis B Virus Chronic Infection
* The AAFP recommends against routinely screening the general asymptomatic population for chronic HBV infection. (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspshepb.htm )
► Hepatitis C Virus (HCV) Infection
* The AAFP recommends against routine screening for HCV infection in asymptomatic adults who are not at increased risk (general population) for infection. (Grade: D recommendation) Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspshepc.htm )
* The AAFP found insufficient evidence to recommend for or against routine screening for HCV infection in adults at high risk for infection. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspshepc.htm )
► Human Immunodeficiency Virus (HIV)
* The AAFP strongly recommends that physicians screen for HIV all adolescents and adults at increased risk for HIV infection. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations for discussion of risk factors: http://www.uspreventiveservicestaskforce.org/uspstf/uspshivi.htm ) Also see: HIV Policy Statement (August 2006)
* The AAFP makes no recommendation for or against routinely screening for HIV in adolescents and adults who are not at increased risk for HIV infection. (Grade: C recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations for discussion of risk factors: http://www.uspreventiveservicestaskforce.org/uspstf/uspshivi.htm ) Also see: HIV Policy Statement (August 2006)
* The AAFP recommends that clinicians screen all pregnant women for HIV. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspshivi.htm ) Also see: HIV Policy Statement (August 2006)
► Hormone Replacement Therapy
* The AAFP recommends against the routine use of combined estrogen and progestin for the prevention of chronic conditions in postmenopausal women. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspspmho.htm )
* The AAFP recommends against the routine use of unopposed estrogen for the prevention of chronic conditions in postmenopausal women who have had a hysterectomy. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspspmho.htm )
► Hypertension
The AAFP strongly recommends screening for high blood pressure in adults aged 18 and older. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspshype.htm )
* The AAFP concludes that the evidence is insufficient to recommend for or against routine screening for high blood pressure in children and adolescents to reduce the risk of cardiovascular disease. (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspshype.htm )
► Illicit Drug Use
The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening adolescents, adults, and pregnant women for illicit drug use. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsdrug.htm )
► Immunization
- The AAFP strongly recommends immunizing all children 0 to 6 years of age using the AAFP recommendations unless contraindicated. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Recommended Childhood Immunization Schedule: http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/immunization/childhoodimmunizationschedule.Par.0001.File.dat/2010ChildhoodImmunizationschedulefinal121709.pdf )
- The AAFP strongly recommends immunizing children 0 to 6 years who are between doses for vaccinations with the AAFP recommendation unless contraindicated. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Recommended Catch-up Immunization Schedule: http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/immunization/catchup.Par.0001.File.tmp/2010RecommendedCatchupSchedulefinal121709.pdf )
* The AAFP strongly recommends immunizing all adolescents 7 to 18 years of age using the AAFP recommendations unless contraindicated. (Grade: A recommendation) (Recommended Adolescent Immunization Schedule: http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/immunization/adolescenimmsched.Par.0001.File.tmp/2010AdolescentImmunizationschedulefinal121709.pdf )
- The AAFP strongly recommends immunizing adolescents 7 to 18 years who are between doses for vaccinations with the AAFP recommendation unless contraindicated. (Grade: A recommendation) (Recommended Catch-up Immunization Schedule: http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/immunization/catchup.Par.0001.File.tmp/08catch-up.pdf )
- The AAFP strongly recommends immunizing all adults using the AAFP recommendations unless contraindicated. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Recommended Adult Immunization Schedule: http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/immunization/adultsched07-08.Par.0001.File.tmp/2010AdultImmSched01152010.pdf )
► Iron Deficiency Anemia
* The AAFP recommends routine screening for iron deficiency anemia in asymptomatic pregnant women. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsiron.htm )
* The AAFP concludes that the evidence is insufficient to recommend for or against routine screening for iron deficiency anemia in asymptomatic children aged 6 to 12 months. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsiron.htm )
► Lead Poisoning
^ The AAFP concludes that evidence is insufficient to recommend for or against routine screening for elevated blood lead levels in asymptomatic children aged 1 to 5 years who are at increased risk. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspslead.htm )
^^ The AAFP recommends against routine screening for elevated blood levels in asymptomatic children aged 1 to 5 years who are at average risk. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspslead.htm )
^^^The AAFP recommends against routine screening for elevated blood levels in asymptomatic pregnant women. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspslead.htm )
► Lipid Disorders
> The AAFP recommends screening men aged 35 and older for lipid disorders. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschol.htm )
>> The AAFP recommends screening men aged 20 to 35 for lipid disorders if they are at increased risk for coronary heart disease. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschol.htm )
>>> The AAFP recommends screening women aged 45 and older for lipid disorders if they are at increased risk for coronary heart disease. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschol.htm )
>>>> The AAFP recommends screening women aged 20 to 45 for lipid disorders if they are at increased risk for coronary heart disease. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschol.htm )
>>>>>> The AAFP makes no recommendation for or against routine screening for lipid disorders in men aged 20 to 35, or in women aged 20 and older who are not at increased risk for coronary heart disease. (Grade: C recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschol.htm )
>>>>>>>> The AAFP concludes that the evidence is insufficient to recommend for or against routine screening for lipid disorders in infants, children, adolescents, or young adults (up to age 20). (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschlip.htm )
► Lung Cancer
* The AAFP recommends against the use of chest x-ray and/or sputum cytology in asymptomatic persons for lung cancer screening. (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspslung.htm )
► Neural Tube Defects, Prevention, Folic Acid Supplementation
* The AAFP recommends that all women planning or capable of pregnancy take a daily supplement containing 0.43 to 0.8 mg (400 to 800 μg) of folic acid. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsnrfol.htm )
► Obesity
- The AAFP recommends that family physicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults. Intensive counseling involves more than one session per month for at least 3 months. (Grade: B Recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsobes.htm )
- The AAFP recommends that clinicians screen children aged 6 years and older for obesity and offer them or refer them to comprehensive, intensive behavioral interventions to promote improvement in weight status. (February 2010) (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: [The definitions for specific interventions (targeted to diet and physical activity) and intensity (>25 hours with child and/or family over 6 months) are noted in the clinical considerations] http://www.uspreventiveservicestaskforce.org/uspstf/uspschobes.htm )
► ◘ Oral Cancer
* The AAFP concludes that the evidence is insufficient to recommend for or against routinely screening adults for oral cancer. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsoral.htm )
► Osteoporosis
* The AAFP recommends routinely screening women aged 65 and older for osteoporosis. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsoste.htm )
* The AAFP recommends routinely screening women aged 60 and older at increased risk for osteoporotic fractures. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsoste.htm )
► Ovarian Cancer
* The AAFP recommends against routine screening for ovarian cancer. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsovar.htm )
* The AAFP recommends that women whose family history is associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes be referred for genetic counseling and evaluation for BRCA testing. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrgen.htm )
* The AAFP recommends against routine referral for genetic counseling or routine BRCA testing for women whose family history is not associated with increased risk for deleterious mutations in BRCA1 or BRCA2. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrgen.htm )
► Pancreatic Cancer
The AAFP recommends against routine screening for pancreatic cancer in asymptomatic adults using abdominal palpation, ultrasonography, or serologic markers. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspspanc.htm )
► Peripheral Arterial Disease
The AAFP recommends against routine screening for peripheral arterial disease (PAD). (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspspard.htm )
► Phenylketonuria
The AAFP recommends ordering screening test for phenylketonuria in neonates. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsspku.htm )
► Physical Activity
The AAFP recognizes that regular physical activity is desirable. The effectiveness of physician's advice and counseling in this area is uncertain. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsphys.htm )
► Prostate Cancer
* The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening in men younger than age 75 years. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsprca.htm )
* The AAFP recommends against screening for prostate cancer in men age 75 years or older. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsprca.htm )
► Pulmonary Chronic Obstructive Disease
* The AAFP recommends against screening asymptomatic adults for chronic obstructive pulmonary disease (COPD) using spirometry. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspscopd.htm )
► Rh (D) Incompatibility
The AAFP strongly recommends Rh (D) blood typing and antibody testing for all pregnant women during their first visit for pregnancy-related care. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsdrhi.htm )
The AAFP recommends repeated Rh (D) antibody testing for all unsensitized Rh (D)-negative women at 24 to 28 weeks' gestation. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsdrhi.htm )
► Scoliosis
* The AAFP recommends against the routine screening of asymptomatic adolescents for idiopathic scoliosis. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsaisc.htm )
► Sexually Transmitted Infections
^ The AAFP recommends high-intensity behavioral counseling to prevent STIs for all sexually active adolescents and for adults at increased risk for STIs. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations for risk assessment: http://www.uspreventiveservicestaskforce.org/uspstf/uspsstds.htm )
^ The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of behavioral counseling to prevent STIs in non-sexually active adolescents and in adults not at increased risk for STIs. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsstds.htm )
► Sickle Cell Disease
* The AAFP recommends screening for sickle cell disease in all newborns. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspshemo.htm )
► Skin Cancer
The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of using a whole-body skin examination by a primary care clinician or patient skin self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsskca.htm )
► Speech and Language Delay
. The AAFP concludes that the evidence is insufficient to recommend for or against routine use of brief, formal screening instruments in primary care to detect speech and language delay in children up to 5 years of age. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspschdv.htm )
► Syphilis
- The AAFP strongly recommends that clinicians screen persons at increased risk for syphilis infection. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspssyph.htm )
- The AAFP recommends against routine screening of asymptomatic persons who are not at increased risk for syphilis infection. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspssyph.htm )
- The AAFP strongly recommends that clinicians screen all pregnant women for syphilis infection. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspssyph.htm )
► Testicular Cancer
The AAFP recommends against routine screening for testicular cancer in asymptomatic adolescents and adult males. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspstest.htm )
► Thyroid Cancer
* The AAFP recommends against the use of ultrasound screening for thyroid cancer in asymptomatic persons. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsthca.htm )
► Thyroid Disease
The AAFP concludes that the evidence is insufficient to recommend for or against routine screening for thyroid disease in adults. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Consideration: http://www.uspreventiveservicestaskforce.org/uspstf/uspsthyr.htm )
► Thyroid Function Abnormalities
The AAFP strongly recommends ordering screening test for thyroid function abnormalities in neonates.
► Tobacco Use
* The AAFP recommends that clinicians screen all adults for tobacco use and provide tobacco cessation interventions for those who use tobacco products. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspstbac.htm )
* The AAFP strongly recommends that clinicians screen all pregnant women for tobacco use and provide 5 to 15 minutes of smoking cessation counseling using messages and self-help materials tailored for pregnant smokers. (Grade: A recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspstbac.htm )
* The AAFP recognizes avoidance of tobacco products by children and adolescents is desirable. The effectiveness of physician advice and counseling in this area is uncertain. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspstbac.htm )
► Tuberculosis (TB)
The AAFP strongly recommends screening for TB by applying the Mantoux test to patients at high risk for tuberculosis, including those with close contacts to person with known or suspected TB, health care workers, immigrants from countries with high TB prevalence, HIV positive individuals, alcoholics, injection drug users, residents of long term care facilities, and medically underserved low income people.
► Visual Difficulties
* The AAFP concludes that the current evidence is insufficient to assess the balance of benefit and harms of screening for visual acuity for the improvement of outcomes in older adults. (Grade I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsviseld.htm )
► Visual Impairment
* The AAFP recommends screening to detect amblyopia, strabismus, and defects in visual acuity in children younger than age 5 years. (Grade: B recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsvsch.htm )
► Vitamin Supplementation, for Cancer and Heart Disease
* The AAFP concludes that the evidence is insufficient to recommend for or against the use of supplements of vitamins A, C, or E; multivitamins with folic acid; or antioxidant combinations for the prevention of cancer or cardiovascular disease. (Grade: I recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsvita.htm )
* The AAFP recommends against the use of beta-carotene supplements, either alone or in combination, for the prevention of cancer or cardiovascular disease. (Grade: D recommendation) (Grade Definition: http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#pre ) (Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsvita.htm )
Definitions:
Grades of Recommendation
The AAFP grading system for the recommendations that occurred during or after May 2007 includes:
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 against routinely providing the service. There may be considerations that support providing the service in an individual patient. 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.
The AAFP grading system for those recommendations before May 2007 includes:
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 exists 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.
open here please:
http://guideline.gov/content.aspx?f=rss&id=15915
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