1. Component 1: Introduction to Health Care and Public Health in the U.S.
1.9: Unit 9: The evolution and reform of healthcare in the US
1.9b:Clinical Practice Guidelines
Component 1/Unit 9b
Health IT Workforce Curriculum Version 1.0/Fall 2010 1

2. Clinical Practice Guidelines: Definition
Systematically developed statements
Assist practitioner and patient decision-making
Intended for specific clinical circumstances
Recommendations that are based on evidence obtained by conducting a systematic review
Guidelines delineate the role of specific diagnostic and treatment modalities in diagnosis and management of a disease
Component 1/Unit 9b
Health IT Workforce Curriculum Version 1.0/Fall 2010 2

3. Clinical Practice Guidelines: Purpose
To help clinicians and patients make appropriate decisions about health care
How do guidelines achieve this?
By specifying a set of generally accepted approaches
By defining appropriate practices
Example of clinical practice guidelines dissemination website:
National guidelines clearinghouse
Component 1/Unit 9b
Health IT Workforce Curriculum Version 1.0/Fall 2010

4. U.S. Preventive Services Task Force (USPSTF)
Independent panel of experts in prevention and evidence-based medicine
Composed of primary care providers
Conducts scientific evidence reviews of a broad range of clinical preventive health care services
Develops recommendations
Component 1/Unit 9b
Health IT Workforce Curriculum Version 1.0/Fall 2010

5. Health IT Workforce Curriculum Version 1.0/Fall 2010
USPTF Grades
A The USPSTF recommends the service
High certainty of substantial net benefit
Suggestions for practice: Offer or provide this service
B The USPSTF recommends the service
High certainty of moderate net benefit or moderate certainty of moderate to substantial net benefit
Component 1/Unit 9b
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6. USPSTF Grades (continued)
C: Recommends against routinely providing the service. Tailor recommendations to individual patients
At least moderate certainty that the net benefit is small
Suggestions for practice: Offer or provide this service only if other considerations support the offering or providing the service in an individual patient
D: Recommends against the service.
Moderate or high certainty of no net benefit or that harms outweigh benefits
Suggestions for practice: Discourage the use of this service
Component 1/Unit 9b
Health IT Workforce Curriculum Version 1.0/Fall 2010

7. USPSTF Grades (continued)
I Statement: Current evidence is insufficient to assess the balance of benefits and harms of the service
Suggestions for practice: Read the clinical considerations section of USPSTF Recommendation Statement. If the service is offered, patients should understand the uncertainty about the balance of benefits and harms
Component 1/Unit 9b
Health IT Workforce Curriculum Version 1.0/Fall 2010