The Guide to Clinical Preventive Services 2008 - part 8 potx

■ Increased IOP, family history, older age, and being of African American descent place an individual at increased risk for glaucoma. Older African Americans have a higher prevalence of glaucoma and perhaps a more rapid disease progression, and if it is shown that screening for glaucoma reduces the development of visual impairment, African Americans would likely have greater absolute benefit than whites. People with a limited life expectancy would likely have little to gain from glaucoma screening. ■ The natural history of glaucoma is heterogeneous and not well defined. There is a subgroup of people with POAG in whom there is either no disease progression, or the progression is so slow that the condition would never have an important effect on their vision. The size of this subgroup is uncertain and may depend on the ethnicity and age of the population. Others experience more rapidly progressing disease, leading to reduced vision- related function within 10 years. Whether an individual’s glaucoma will progress cannot be predicted with precision, but those with higher levels of IOP and worse visual fields at baseline, and those who are older, tend to be at greater risk for the more rapid progression of glaucoma. Whether the rate of progression of visual field defects remains uniform throughout the course of glaucoma is unknown. 174 Screening for Glaucoma ■ Measurement of visual fields can be difficult. The reliability of a single visual field measurement may be low; several consistent visual field measurements are needed to establish the presence of defects. Dilated opthalmoscopy or slit lamp exam are used by specialists to examine changes in the optic disc; however, even experts vary in their ability to detect glaucomatous optic disc progression. Additionally, there is no agreed-upon single standard to define and measure progression of visual field defects. The primary treatments for POAG reduce IOP; these include medications, laser therapy, or surgery. These treatments effectively reduce the development and progression of small, visual field defects. The magnitude of their effectiveness, however, in reducing impairment in vision-related function is uncertain. Harms caused by these interventions include formation of cataracts, harms resulting from cataract surgery, and harms of topical medication. This USPSTF recommendation was first published by: Agency for Healthcare Research and Quality. Rockville, MD, March 2005. http://www.preventiveservices.ahrq.gov. 175 Screening for Glaucoma [...]... recommendation on this topic during publication of The Guide to Clinical Preventive Services 20 08 For the most recent recommendation, please visit our Web site at http://www.preventiveservices.ahrq.gov or the USPSTF’s Electronic Preventive Services Selector (ePSS) at http://epss.ahrq.gov You can search the ePSS for recommendations by patient age, sex, and pregnancy status, and you can download the recommendations... Joint Surg Br 2002 ;84 (3):41 8- 4 25 6 Konigsberg DE, Karol LA, Colby S, O’Brien S Results of medial open reduction of the hip in infants with developmental dislocation of the hip J Pediatr Orthop 2003;23(1): 1-9 This USPSTF recommendation was first published in Pediatrics 2006;117 :89 8- 9 02 187 Screening for Idiopathic Scoliosis in Adolescents Summary of Recommendation The U.S Preventive Services Task Force... adolescents reflects the paucity of good-quality evidence on the effectiveness of interventions for this problem in the clinical setting There is little evidence for effective, family-based or individual approaches for the treatment of overweight in children and adolescents in primary care settings The Centers for Disease Control and Prevention’s (CDC’s) Guide to Community Preventive Services has identified... scoliosis: a 50-year natural history study JAMA 2003; 289 (5):55 9-5 67 This USPSTF recommendation was first published by: Agency for Healthcare Research and Quality, Rockville, MD June 2004 http://www.preventiveservices.ahrq.gov 189 Screening for Lipid Disorders in Children Summary of Recommendation The U.S Preventive Services Task Force (USPSTF) concludes that the evidence is insufficient to recommend... children with other medical problems such as hearing deficits or craniofacial abnormalities, are not considered in this recommendation The results of studies of other risk factors are inconsistent, so the USPSTF was unable to develop a list of specific risk factors to guide primary care providers in selective screening The most consistently reported risk factors, however, include a family history of speech... has been recommended by other groups as a part of appropriate care for these children I The use of family history as a screening tool for dyslipidemia has variable accuracy largely because definitions of a positive family history and lipid threshold values vary substantially Screening using family history as defined by the National Cholesterol Education Program (NCEP) and the American Academy of Pediatrics... treatment of congenital dislocation of the hip J Bone and Joint Surgery 1962;44:29 2-3 01 4 Standing Medical Advisory Committee Screening for the detection of congenital dislocation of the hip Arch Dis Child 1 986 ;61(9):92 1-9 26 5 Cashman JP, Round J, Taylor G, Clarke NM The natural history of developmental dysplasia of the hip after early supervised treatment in the Pavlik harness A prospective, longitudinal... important to measure and monitor growth over time in all children as an indicator of health and development The number of children and adolescents who are overweight has more than doubled since the early 1970s, with the prevalence of overweight (BMI > 95th percentile for age and sex) for children aged 6 to 19 years now at approximately 15 percent The conclusion that there is insufficient evidence to recommend... identifiable risk factors I Screening tests for DDH have limited accuracy The most common methods of screening are serial physical examinations of the hip and lower extremities, using the Barlow and Ortolani procedures, and ultrasonography The Barlow examination is performed by adducting a flexed hip with gentle posterior force to identify a dislocatable 185 Screening for Hip Dysplasia hip The Ortolani examination... 1 98 Screening for Speech and Language Delay in Preschool Children Summary of Recommendation The U.S Preventive Services Task Force (USPSTF) concludes that the evidence is insufficient to recommend for or against routine use of brief, formal screening instruments in primary care to detect speech and language delay in children up to 5 years of age Grade: I Statement Clinical Considerations I It is the . Children Newborn Hearing Screening 193 NOTE: The USPSTF revised its recommendation on this topic during publication of The Guide to Clinical Pr eventive Services 20 08. For the most r ecent recommendation,. recommendation statements in this Guide are abridged. To see the full recommendation statements and recommendations published after March 20 08, go to http://www.preventiveservices.ahrq.gov. Section. specialists to examine changes in the optic disc; however, even experts vary in their ability to detect glaucomatous optic disc progression. Additionally, there is no agreed-upon single standard to define and