Challenges in Evidence Based Prevention

Holistic Hormone Balance

Natural Menopause Relief Secrets

Get Instant Access

Evidence-based prevention faces three levels of challenges: determining which services are effective (i.e., state of the science); delivering the message to prioritize the effective services; and applying the evidence in clinical practice. Conducting systematic reviews of literature to determine which preventive services are effective is time and resource intensive. Such reviews favor a team approach rather than one clinician conducting these reviews alone. Prevention literature is limited in some areas, especially harms of preventive services, and because of these limitations, many guidelines use expert opinion as a type of evidence supporting recommendations.

Conflicting guidelines create confusing messages. For example, conflicting guidelines leave clinicians without clear direction about what to do in their practices. Clinicians may have difficulty determining the methodologies of each specific guideline (e.g., consensus opinion, evidence based, evidence informed) and deciding which guideline to use in their practices. Evidence-based guidelines with transparent methodology (e.g., USPSTF) are reproducible and more reliable for implementation. Prioritizing effective preventive services leads to decreased overuse of ineffective services and increased use of effective services.

Systems challenges, including a lack of linkages to community resources, delivery system support, and clinical information support (e.g., reminder systems, electronic health

Framework and key questions 1

Postmenopausal women

Postmenopausal women

Figure 6-1 U.S. Preventive Services Task Force (USPSTF) framework for osteoporosis screening. Key questions addressed include the following: (1) Does screening using risk factor assessment or bone density testing reduce fractures? (2) Does risk factor assessment accurately identify women who may benefit from bone density testing? (3) Do bone density measurements accurately identify women who may benefit from treatment? (4) What are the harms of screening? (5) Does treatment reduce the risk of fractures in women identified by screening? (6) What are the harms of treatment?

Figure 6-1 U.S. Preventive Services Task Force (USPSTF) framework for osteoporosis screening. Key questions addressed include the following: (1) Does screening using risk factor assessment or bone density testing reduce fractures? (2) Does risk factor assessment accurately identify women who may benefit from bone density testing? (3) Do bone density measurements accurately identify women who may benefit from treatment? (4) What are the harms of screening? (5) Does treatment reduce the risk of fractures in women identified by screening? (6) What are the harms of treatment?

records), make it difficult to apply evidence-based prevention in practice. A systematic approach to offering preventive services enables a busy clinician to prioritize the most effective services. A systematic team approach ensures that immunizations are administered on time, screening tests are done appropriately, and counseling services are offered to those who need them.

Was this article helpful?

0 0
From PMS To PPD

From PMS To PPD

The Stages Of A Woman’s Life Are No Longer A Mystery. Get Instant Access To Valuable Information On All The Phases Of The Female Body From Menstruation To Menopause And Everything In Between.

Get My Free Ebook


Post a comment