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E. Albert Reece - One of the best experts on this subject based on the ideXlab platform.
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Recommendations of the IOM Clinical Preventive Services for women committee: implications for obstetricians and gynecologists.
Current opinion in obstetrics & gynecology, 2011Co-Authors: Rebekah E. Gee, Claire D. Brindis, Angela Diaz, Francisco A.r. Garcia, Kimberly D. Gregory, Magda G. Peck, E. Albert ReeceAbstract:PURPOSE OF REVIEW In July 2011, in response to language in the Affordable Care Act (ACA) the Office of the Assistant Secretary for Planning and Evaluation of the US Department of Health and Human Services (HHS) tasked the Institute of Medicine (IOM) to develop a report on the Clinical Preventive Services necessary for women. The committee proposed eight new Clinical Preventive Service recommendations aimed at closing significant gaps in Preventive healthcare. This article reviews the process, findings, and the implications for obstetrician gynecologists and other primary care clinicians. Obstetricians and gynecologists play a major role in delivering primary care to women and many of the Services recommended by the Committee are part of the core set of obstetrics and gynecology Services. RECENT FINDINGS The women's health amendment to the ACA (Federal Register, 2010) requires that new private health plans cover - with no cost-sharing requirements - Preventive healthcare Services for women. Congress requested that a review be conducted to ascertain whether there were any additional needed Preventive Services specific to women's health that should be included. SUMMARY The IOM Committee on Preventive Services for Women recommended eight Clinical measures specific to women's health that should be considered for coverage without co-payment. The US Department of HHS reviewed and adopted these recommendations, and, as a result, new health plans will need to include these Services as part of insurance policies with plan years beginning on or after 1 August 2012. The authors discuss the implications of the IOM recommendations on practicing clinicians and on their potential impact on women's health and well being.
Alex H Krist - One of the best experts on this subject based on the ideXlab platform.
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framework for using risk stratification to improve Clinical Preventive Service guidelines
American Journal of Preventive Medicine, 2018Co-Authors: Jennifer S Lin, Corinne V Evans, David C Grossman, Chienwen Tseng, Alex H KristAbstract:People should only receive a Preventive Service if the potential benefits of the Service outweigh the potential harms. Both benefits and risks may vary for different populations. Thus, it is Clinically important to understand when and how guidelines for Preventive Services should be stratified according to the underlying risk of the population. For example, Preventive Services may be risk stratified with specific Clinical recommendations based on age, sex, race/ethnicity, family history, genotype, behavior risks, or comorbidities. This paper articulates the conceptual approach and practical tools that were developed for consideration by the U.S. Preventive Services Task Force to determine if and how risk stratification should be incorporated into Clinical guidelines. This approach is described in an algorithm with six sequential questions: (1) Are there Clinically relevant subpopulations? (2) Are there credible subgroup analyses for these subpopulations? (3) Do subgroup analyses show Clinically important differences? (4) Do these differences result in variation of net benefit, or does the evidence only exist in persons with a narrow spectrum of risk? (5) Can the subpopulations be easily identified? and (6) Does a well-validated multivariate risk tool improve identification of Clinically relevant subpopulations compared with a simpler approach? This framework allows for a systematic approach to determine if and how to incorporate evidence for specific populations, a consistent application of critical thinking about this evidence, and transparent communication about the derivation of risk-stratified recommendations or evidence gaps.
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Use of Decision Models in the Development of Evidence-Based Clinical Preventive Services Recommendations: Methods of the U.S. Preventive Services Task Force
Annals of internal medicine, 2016Co-Authors: Douglas K. Owens, Alex H Krist, Evelyn P. Whitlock, Jillian T Henderson, Michael Pignone, Kirsten Bibbins-domingo, Susan J. Curry, Karina W. Davidson, Mark H. Ebell, Matthew W. GillmanAbstract:The U.S. Preventive Services Task Force (USPSTF) develops evidence-based recommendations about Preventive care based on comprehensive systematic reviews of the best available evidence. Decision models provide a complementary, quantitative approach to support the USPSTF as it deliberates about the evidence and develops recommendations for Clinical and policy use. This article describes the rationale for using modeling, an approach to selecting topics for modeling, and how modeling may inform recommendations about Clinical Preventive Services. Decision modeling is useful when Clinical questions remain about how to target an empirically established Clinical Preventive Service at the individual or program level or when complex determinations of magnitude of net benefit, overall or among important subpopulations, are required. Before deciding whether to use decision modeling, the USPSTF assesses whether the benefits and harms of the Preventive Service have been established empirically, assesses whether there are key issues about applicability or implementation that modeling could address, and then defines the decision problem and key questions to address through modeling. Decision analyses conducted for the USPSTF are expected to follow best practices for modeling. For chosen topics, the USPSTF assesses the strengths and limitations of the systematically reviewed evidence and the modeling analyses and integrates the results of each to make Preventive Service recommendations.
Mary M. Mccauley - One of the best experts on this subject based on the ideXlab platform.
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Adolescent immunizations and other Clinical Preventive Services: a needle and a hook?
Pediatrics, 2008Co-Authors: Karen R. Broder, Amanda C. Cohn, Benjamin Schwartz, Jonathan D. Klein, Martin Fisher, Daniel B. Fishbein, Christina Mijalski, Gale R. Burstein, Mary Vernon-smiley, Mary M. MccauleyAbstract:Advances in technology have led to development of new vaccines for adolescents, but these vaccines will be added to a crowded schedule of recommended adolescent Clinical Preventive Services. We reviewed adolescent Clinical Preventive health care guidelines and patterns of adolescent Clinical Preventive Service delivery and assessed how new adolescent vaccines might affect health care visits and the delivery of other Clinical Preventive Services. Our analysis suggests that new adolescent immunization recommendations are likely to improve adolescent health, both as a "needle" and a "hook." As a needle, the immunization will enhance an adolescent's health by preventing vaccine-preventable diseases during adolescence and adulthood. It also will likely be a hook to bring adolescents (and their parents) into the clinic for adolescent health care visits, during which other Clinical Preventive Services can be provided. We also speculate that new adolescent immunization recommendations might increase the proportion and quality of other Clinical Preventive Services delivered during health care visits. The factor most likely to diminish the positive influence of immunizations on delivery of other Clinical Preventive Services is the additional visit time required for vaccine counseling and administration. Immunizations may "crowd out" delivery of other Clinical Preventive Services during visits or reduce the quality of the Clinical Preventive Service delivery. Complementary strategies to mitigate these effects might include prioritizing Clinical Preventive Services with a strong evidence base for effectiveness, spreading Clinical Preventive Services out over several visits, and withholding selected Clinical Preventive Services during a visit if the prevention activity is effectively covered at the community level. Studies are needed to evaluate the effect of new immunizations on adolescent Preventive health care visits, delivery of Clinical Preventive Services, and health outcomes.
Rebekah E. Gee - One of the best experts on this subject based on the ideXlab platform.
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Recommendations of the IOM Clinical Preventive Services for women committee: implications for obstetricians and gynecologists.
Current opinion in obstetrics & gynecology, 2011Co-Authors: Rebekah E. Gee, Claire D. Brindis, Angela Diaz, Francisco A.r. Garcia, Kimberly D. Gregory, Magda G. Peck, E. Albert ReeceAbstract:PURPOSE OF REVIEW In July 2011, in response to language in the Affordable Care Act (ACA) the Office of the Assistant Secretary for Planning and Evaluation of the US Department of Health and Human Services (HHS) tasked the Institute of Medicine (IOM) to develop a report on the Clinical Preventive Services necessary for women. The committee proposed eight new Clinical Preventive Service recommendations aimed at closing significant gaps in Preventive healthcare. This article reviews the process, findings, and the implications for obstetrician gynecologists and other primary care clinicians. Obstetricians and gynecologists play a major role in delivering primary care to women and many of the Services recommended by the Committee are part of the core set of obstetrics and gynecology Services. RECENT FINDINGS The women's health amendment to the ACA (Federal Register, 2010) requires that new private health plans cover - with no cost-sharing requirements - Preventive healthcare Services for women. Congress requested that a review be conducted to ascertain whether there were any additional needed Preventive Services specific to women's health that should be included. SUMMARY The IOM Committee on Preventive Services for Women recommended eight Clinical measures specific to women's health that should be considered for coverage without co-payment. The US Department of HHS reviewed and adopted these recommendations, and, as a result, new health plans will need to include these Services as part of insurance policies with plan years beginning on or after 1 August 2012. The authors discuss the implications of the IOM recommendations on practicing clinicians and on their potential impact on women's health and well being.
Angela Diaz - One of the best experts on this subject based on the ideXlab platform.
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Recommendations of the IOM Clinical Preventive Services for women committee: implications for obstetricians and gynecologists.
Current opinion in obstetrics & gynecology, 2011Co-Authors: Rebekah E. Gee, Claire D. Brindis, Angela Diaz, Francisco A.r. Garcia, Kimberly D. Gregory, Magda G. Peck, E. Albert ReeceAbstract:PURPOSE OF REVIEW In July 2011, in response to language in the Affordable Care Act (ACA) the Office of the Assistant Secretary for Planning and Evaluation of the US Department of Health and Human Services (HHS) tasked the Institute of Medicine (IOM) to develop a report on the Clinical Preventive Services necessary for women. The committee proposed eight new Clinical Preventive Service recommendations aimed at closing significant gaps in Preventive healthcare. This article reviews the process, findings, and the implications for obstetrician gynecologists and other primary care clinicians. Obstetricians and gynecologists play a major role in delivering primary care to women and many of the Services recommended by the Committee are part of the core set of obstetrics and gynecology Services. RECENT FINDINGS The women's health amendment to the ACA (Federal Register, 2010) requires that new private health plans cover - with no cost-sharing requirements - Preventive healthcare Services for women. Congress requested that a review be conducted to ascertain whether there were any additional needed Preventive Services specific to women's health that should be included. SUMMARY The IOM Committee on Preventive Services for Women recommended eight Clinical measures specific to women's health that should be considered for coverage without co-payment. The US Department of HHS reviewed and adopted these recommendations, and, as a result, new health plans will need to include these Services as part of insurance policies with plan years beginning on or after 1 August 2012. The authors discuss the implications of the IOM recommendations on practicing clinicians and on their potential impact on women's health and well being.