Screening Recommendations Flashcards
What fields are represented in USPSTF?
Preventative medicine, primary care, internal medicine, family medicine, beds, behavioral health, OB, nursing
Category A
Recommended service-high certainty that the net benefit is substantial
Category B
Recommended service-high certainty that benefit is moderate or moderate-substantial
Category C
Service is recommended selectively or based on professional judgement/patient preference
Category D
Recommended to NOT do the service, risk outweighs benefit
Category I
Insufficient evidence
How are screening decisions made?
Burden of suffering, sensitivity/specificty/safety of test, prevention effectiveness
Burden of suffering (the D’s)
Death, disease, disability, discomfort, dissatisfaction,destitution
Harms of screening
Risks associated with the test, anxiety, additional diagnostic testing, over-diagnosis, limited benefit
Cardiovascular Disease screening tests
Hypertension, hyperlipidemia, coronary heart disease, carotid artery stenosis, abdominal aortic aneurysm, peripheral artery disease, aspirin prophylaxis
What is considered increased 10-year CVD risk?
> 7.5%
Hypertension
Grade A for 18+, screen every 3-5 years until age 40, then annually
Annually if at increased risk (high BP, obese, African American)
Hypertension Children/adolescents
AAP: >3 years old at every health care episode
NHLB, bright futures, AHA: annually beginning at age 3
Hyperlipidemia
Primary prevention- low-mod dose statin Grade B: age 40-75, no hx of CVD, >1 CVD risk factor &10 year risk >10%
Coronary Heart Disease
hs-CRP, ankle-brachial index, coronary artery calcification score with no hx-insufficient evidence
EKG-Grade D
Carotid Artery Stenosis
Grade D- only 10% ischemic stroke caused by CAS, 1% of CAS are asymptomatic
Abdominal Aortic Aneurysm
Men-Grade B if 65-75 who’ve ever smoked
Women- Grade D who’ve never smoked, insufficient evidence if they have smoked