Douglas K. Owens, MD, MS; Evelyn P. Whitlock, MD, MPH; Jillian Henderson, PhD, MPH; Michael P. Pignone, MD, MPH; Alex H. Krist, MD, MPH; Kirsten Bibbins-Domingo, PhD, MD, MAS; Susan J. Curry, PhD; Karina W. Davidson, PhD, MASc; Mark Ebell, MD, MS; Matthew W. Gillman, MD, SM; David C. Grossman, MD, MPH; Alex R. Kemper, MD, MPH, MS; Ann E. Kurth, PhD, RN, MSN, MPH; Michael Maciosek, PhD; Albert L. Siu, MD, MSPH; Michael L. LeFevre, MD, MPH; on behalf of the U.S. Preventive Services Task Force* (*)
Financial Support: This article is based in part on a report by the Kaiser Permanente Research Affiliates Evidence-based Practice Center under contract HHS-290-2007-10057-I to the Agency for Healthcare Research and Quality (AHRQ), Rockville, Maryland. AHRQ staff provided oversight for the project and assisted in external review of the companion draft report.
Disclosures: Dr. Whitlock reports other (contract to perform support services for the USPSTF that resulted in the background paper supporting this manuscript) from AHRQ during the conduct of the study. Dr. Henderson reports grants from AHRQ during the conduct of this work. Dr. Pignone reports having developed and revised decision models for preventive services (including aspirin to prevent cardiovascular disease and CRC screening) that are considered by the USPSTF. Dr. Maciosek reports grants from AHRQ during the conduct of this work. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2531.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Requests for Single Reprints: Reprints are available from the USPSTF Web site (www.uspreventiveservicestaskforce.org).
Current Author Addresses: Dr. Owens: Stanford University School of Medicine, 291 Campus Drive, Room LK3C02, Stanford, CA 94305.
Dr. Whitlock: Patient-Centered Outcomes Research Institute, 1828 L Street NW, Suite 900, Washington, DC 20036.
Dr. Henderson: Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest, 3800 North Interstate Avenue, Portland, OR 97227.
Dr. Pignone: University of North Carolina at Chapel Hill, School of Medicine, 5045 Old Clinic Building, Chapel Hill, NC 27707.
Dr. Krist: VCU-Fairfax Family Medicine Residency, 3650 Joseph Siewick Drive, Suite 400, Fairfax, VA 22033.
Dr. Bibbins-Domingo: Department of General Internal Medicine, University of California, San Francisco, Box 1364, San Francisco, CA 94143.
Dr. Curry: University of Iowa, College of Public Health, 105 River Street, Iowa City, IA 52242.
Dr. Davidson: Columbia University Medical Center, 622 East 168th Street, New York, NY 10032.
Dr. Ebell: University of Georgia, B.S. Miller Hall Room 233, Health Sciences Campus, 101 Buck Road, Athens, GA 30602.
Dr. Gillman: Department of Population Medicine, Harvard Medical School, 401 Park Drive, Suite 401, Boston, MA 02215.
Dr. Grossman: Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101.
Dr. Kemper: Department of Pediatrics, Duke University, 4020 North Roxboro Street, Durham, NC 27704.
Dr. Kurth: Yale School of Nursing, Yale University West Campus, PO Box 27399, West Haven, CT 06516.
Dr. Maciosek: Health Partners Institute, PO Box 1524, Minneapolis, MN 55440.
Dr. Siu: Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1070, New York, NY 10029.
Dr. LeFevre: University of Missouri, School of Medicine, 1 Hospital Drive, Medical Sciences Building, Columbia, MO 65212.
Author Contributions: Conception and design: D.K. Owens, E.P. Whitlock, A.H. Krist, K. Bibbins-Domingo, S.J. Curry, K.W. Davidson, M. Ebell, M.W. Gillman, D.C. Grossman, M. Maciosek, M.L. LeFevre.
Analysis and interpretation of the data: D.K. Owens, E.P. Whitlock, M.P. Pignone, A.H. Krist, K. Bibbins-Domingo, M. Ebell, M.W. Gillman, D.C. Grossman.
Drafting of the article: D.K. Owens, E.P. Whitlock, A.H. Krist, K. Bibbins-Domingo, K.W. Davidson, M.W. Gillman, D.C. Grossman, A.R. Kemper, M. Maciosek, M.L. LeFevre.
Critical revision of the article for important intellectual content: D.K. Owens, E.P. Whitlock, J. Henderson, M.P. Pignone, A.H. Krist, K. Bibbins-Domingo, M. Ebell, M.W. Gillman, D.C. Grossman, A.R. Kemper, A.E. Kurth, M. Maciosek, M.L. LeFevre.
Statistical expertise: D.K. Owens, M.W. Gillman.
Obtaining of funding: E.P. Whitlock.
Final approval of the article: M.P. Pignone, A.H. Krist, K. Bibbins-Domingo, S.J. Curry, K.W. Davidson, M. Ebell, D.C. Grossman, A.R. Kemper, A.E. Kurth, A.L. Siu, M.L. LeFevre.
Administrative, technical, or logistic support: E.P. Whitlock, J. Henderson, A.H. Krist, K.W. Davidson, A.E. Kurth.
Collection and assembly of data: D.K. Owens, E.P. Whitlock, J. Henderson, A.H. Krist, M. Maciosek.
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.
Douglas K. Owens, Evelyn P. Whitlock, Jillian Henderson, Michael P. Pignone, Alex H. Krist, Kirsten Bibbins-Domingo, et al. Use of Decision Models in the Development of Evidence-Based Clinical Preventive Services Recommendations: Methods of the U.S. Preventive Services Task Force. Ann Intern Med. 2016;165:501–508. doi: 10.7326/M15-2531
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Published: Ann Intern Med. 2016;165(7):501-508.
Published at www.annals.org on 5 July 2016
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