Appendix D. About the U.S. Preventive Services Task Force
Guide to Clinical Preventive Services, 2012
Created in 1984, the U.S. Preventive Services Task Force (USPSTF) is an independent group of national experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as:
- Counseling services
- Preventive medications
The Task Force is made up of 16 volunteer members who serve 4-year terms. Members come from the fields of preventive medicine and primary care, including internal medicine, family medicine, pediatrics, behavioral health, obstetrics and gynecology, and nursing. The Task Force is led by a chair and two vice-chairs. Members are appointed by the Director of AHRQ. Members must have no substantial conflicts of interest that could impair the integrity of the work of the Task Force. A list of current USPSTF members, including their biographical information, can be found on the USPSTF Web site (www.USPreventiveServicesTaskForce.org).
Since 1998, through acts of the U.S. Congress, the Agency for Healthcare Research and Quality (AHRQ) has been authorized to convene the Task Force and to provide ongoing scientific, administrative, and dissemination support to the Task Force.
The Task Force makes recommendations to help primary care clinicians and patients decide together whether a preventive service is right for a patient's needs. Its recommendations apply to people who have no signs or symptoms of the specific disease or condition to which a recommendation applies and are for services prescribed, ordered, or delivered in the primary care setting.
Task Force recommendations are based on a rigorous review of existing peer-reviewed evidence. The Task Force assesses the effectiveness of a clinical preventive service by evaluating and balancing the potential benefits and harms of the service. The potential benefits include early identification of disease and improvement in health. The potential harms can include adverse effects of the service itself or inaccurate test results that may lead to additional testing, additional risks or unneeded treatment. The Task Force does not explicitly consider costs in its assessment of the effectiveness of a service. The Task Force assigns each recommendation a letter grade (A, B, C, or D grade or an I statement) based on the strength of the evidence and on the balance of benefits and harms of the preventive service. More information on USPSTF recommendation grades and a list of all current USPSTF recommendations can be found on the USPSTF Web site.
The Recommendation Making Process
The USPSTF is committed to making its work as transparent as possible. As part of this commitment, the Task Force provides opportunities for the public to provide input during each phase of the recommendation process.
The phases of the topic development process are described below and illustrated in “Steps the USPSTF Takes to Make a Recommendation” at the end of this appendix.
The USPSTF considers a broad range of clinical preventive services for its recommendations, focusing on screenings, counseling, and preventive medications. Anyone can nominate a topic for consideration by the Task Force.
Research Plan Development
Once the USPSTF selects a topic for review, it works with an Evidence-based Practice Center (EPC) to develop a draft research plan, which guides the recommendation process and includes key questions and target populations. A draft research plan is posted for public comment, and feedback is incorporated into a final research plan.
Evidence Report Development
Using the final research plan as a guide, EPC researchers gather, review, and analyze evidence on the topic and summarize their findings in a detailed evidence report. The evidence report is sent to subject matter experts for review before it is shared with the Task Force. Beginning in 2013, draft evidence reports will also be posted for public comment.
Recommendation Statement Development
Task Force members discuss the evidence report and use the information to determine the effectiveness of a service by weighing the benefits and harms. The USPSTF creates a draft recommendation based on this discussion. The Task Force posts its draft recommendations for public comment and solicits feedback from national stakeholder organizations. All comments are reviewed by the Task Force and used to inform the development of the final recommendation statement.
Final Recommendation Statement
After the public comment period, the USPSTF finalizes the recommendation statement. The final recommendation statement is posted on the USPSTF Web site along with supporting materials and is also published in a peer-reviewed scientific journal.
Please visit the Task Force Web site (www.USPreventiveServicesTaskForce.org) to learn how and when to nominate topics for consideration by the Task Force or to comment on topics in development.
On the Task Force Web site, people can:
- View all current USPSTF recommendations and supporting materials.
- Learn more about the Task Force methods and processes.
- Nominate a new USPSTF member or a topic for a consideration by the Task Force.
- Provide input on specific draft materials during public comment periods.
- Sign up for the USPSTF listserv to receive USPSTF updates.
- Access the Electronic Preventive Services Selector (ePSS), a quick hands-on tool designed to help primary care clinicians and health care teams identify, prioritize, and offer the screening, counseling, and preventive medication services that are appropriate for their patients. The ePSS is available on the Web (epss.ahrq.gov) or as a mobile phone or PDA application.
- Access MyHealthfinder. MyHealthfinder is a tool for consumers that provides personalized recommendations for preventive services based on the U.S. Preventive Services Task Force; the Bright Futures Guidelines; the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP); and the Institute of Medicine's (IOM's) Committee on Preventive Services for Women.
Steps the USPSTF Takes to Make a Recommendation