Screening recommendation

What is screening?
Screening is the testing of apparently healthy populations to
identify previously undiagnosed diseases or people at high risk of developing a disease. Screening aims to detect early disease before it becomes symptomatic. Screening is an important aspect of prevention, but not all

diseases are suitable for screening.

The Principles of Screening

OVERVIEW OF USPSTF RECOMMENDATIONS

USPSTF provide us with an evidence-based recommendations for multiple clinical preventive services.

SPECIFIC CONDITIONS
Cardiovascular disease Hypertension Abdominal aortic aneurysm Cancer morbidity and mortality:
Breast Cervical Colorectal Lung Prostate melanoma

Immunization:
Infleunza Pneumoccal Zocter vaccine

Injury prevetnion
Falls and bone fracture Motor vehcle accidents Domestic violence

Depression Diabetes Lifestyle-related problems

Sexually-transmitted infections
Chlamydia Gonorrrhea HIV

Substance-abuse related problems Vision and hearing problems

WHAT NOT TO DO
Preventive services that are ineffective, targeted to rare conditions, or lead to a greater probability of harms than benefits should not be delivered.

HOW TO EFFICIENTLY DELIVER PREVENTION

Preventive services are more likely to be delivered when patients have an established relationship with an identified clinician. Most preventive services are delivered at the time of a periodic health maintenance visit (a periodic check-up visit) in primary care practices . For people who have no chronic conditions and rarely see a clinician, a periodic health evaluation visit may be the only opportunity to deliver needed preventive care.

HOW TO EFFICIENTLY DELIVER PREVENTION

There are no strict guidelines for the optimal frequency of these periodic visits, and no evidence on which to base optimal frequency recommendations. Annual examinations are not indicated for most younger patients, although people with chronic health issues (such as diabetes) warrant regular visits, with or without a periodic health maintenance visit, independent of age. In the absence of such indications, we suggest periodic health maintenance visits every one to three years for adult patients 49 years, and annually for adults 50 years and older.

HOW TO EFFICIENTLY DELIVER PREVENTION

routine "check-up" visits may be an efficient way to deliver most, but not all, components of preventive care. These visits cannot address the preventive care needs of all patients. Prevention, therefore, should be considered at nearly every visit and the "periodic health maintenance visit" becomes the "continuous health maintenance evaluation." This is particularly true for young adults (age <30 years) who are less likely to have preventive care visits than other age groups, are less likely to have medical insurance, and are at increased risk for depression and suicide, sexually transmitted disease and HIV infection, and substance abuse including binge drinking

HOW TO EFFICIENTLY DELIVER PREVENTION

The design of the periodic check-up visit is another issue. Rather than perform a standardized comprehensive exam on all patients, clinicians need to individualize the visit to meet the specific needs of the patient. Rarely is there a need for a standard head to toe physical examination.