Grade B screenings Flashcards
What is the definition of a grade B screening?
The USPSTF recommends this service. There is high certainty that the net benefit is moderate or these is moderate certainty that the net benefit is moderate to substantial
Suggestions for practice with grade B screenings
providers should provide or offer this service
hyperlipidemia
those who are 40 to 75 years old with no history of cardiovascular disease but have one or more risk factors for CVD and a 10 year CVD risk grater than or equal to 10% should be placed on a low to moderate dose statin
hyperlipidemia after age 75
if there is no history of cardiovascular disease there is insufficient evidence that screening or a low to moderate dose statin is beneficial to the patient
abdominal aortic aneurysm
Men who have ever smoked and are aged 65-75 years old a one time screening with ultrasound is a grade B recommendation
if your male patient has never smoked you can selectively offer screening, but it is not recommended routinely, this is a grade C recommendation
there is insufficient evidence for screen women aged 65-75 roar have smoked
however it is a grade D recommendation if they have never smoked and are aged 65-to 75
aspirin prophylaxis
grade B for adults who are aged. 50 to 59 years old and have a 10 year CVD risk greater or equal to ten percent
and have no risk of bleeding and have a life expectancy of at least 10 years
they must also be willing to take low-dose aspirin daily for at least 10 years
60-69 grade C
younger than 50, insufficient evidence
older than 70, Insufficient evidence
for what diseases is aspirin used as a prophylaxis
cardiovascular disease and colorectal cancer
skin cancer
the screening itself has Insufficient evidence
BUT there is a grade B recommendation for counseling young adults, adolescents, children and parents of young children with fair skin types about minimizing UV exposure radiating in those 6 months old to age 24
once they are over 24 the recommendation becomes a grade C
Breast cancer
grade B screen recommendation every 2 years for those aged 50- 74
grade C for those who are 40-49, approach to screening should be individualized to the patient based on history, etc.
Lung cancer
grade B for adults who are aged 55-80 with a history of smoking
screening for lung cancer
Annual screening with low-dose CT if there is a 30-pack-year smoking history and the patient currently smokes or has quit within the past 15 years
when to discontinue lung cancer screening
once the person has not smoked for 15 years, or develops a health problem substantially limiting life expectancy or the willingness to have curative lung surgery
Chlamydia & Gonorrhea
screen sexually active women who age 24 or older who at are increased risk
there is Insufficient evidence for men
Hepatitis B
Grade B screen those who at high risk
Hepatitis C
screen those at high risk and offer a 1 time screening to adults born between 1945 and 1965
What birth year period should you offer a one time Hep C screening to?
1945 to 1965
depression
screen the general adult population, including including pregnant & postpartum women
major depressive disorder
screen for major depressive disorder in adolescents aged 12-18 y/o
screening tools for depression
Patient Health Questionnaire (PHQ)-2
PHQ-9
Beck Depression Inventory for Primary Care
5-Item World Health Organization Well-Being Index (WHO-5)
PHQ 2 questions
During the last month, have you been bothered by feeling down, depressed, or hopeless?
During the last month, have you been bothered by having little interest or pleasure in doing things?
depression screening for those under 11 years old
insufficient evidence
Tobacco use in children and adolescents
Grade B: provide interventions, including education or brief counseling, to prevent initiation of tobacco use among school-aged children and adolescents
alcohol
screen adults over 18 for unhealthy school use and provide persons engaging in risky or hazardous drinking with brief behavioral counseling internets to reduce unhealthy alcohol use
screening for those 12-17 y/o has insufficient evidence
intimate partner violence
screen women of reproductive age
if they older or vulnerable adults the evidence is insufficient
what should you do if a women screens positive for intimate partner violence
refer to ongoing support services
osteoporosis
screen women 65 y/o and older with bone measurement testing
also screen postmenopausal women younger than 65 y/o who are at increased risk of osteoporosis
Insufficient evidence for men
obesity adults
offer or refer adults with a BMI 30 or over to intensive, multicomponent behavioral interventions
obesity children and adolescents over 6 years over
screen for obesity and offer or refer to comprehensive, intensive behavioral interventions to promote improvements in weight status
vision
vision screening at least once in children aged 3-5 y/o for amblyopia or its risk factors
exercise
recommends exercise interventions to prevent fails in community dwellings 65 years or older who are at increased risk for falls
Sexually active adolescents and adults
intensive behavior consoling for all sexually active adolescents and for adults who are all increased risk for STI
