Brookdale Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York 10029, USA.
Ann Intern Med. 2010 Dec 21;153(12):809-14. doi: 10.7326/0003-4819-153-12-201012210-00007.
The U.S. Preventive Services Task Force (USPSTF) bases its recommendations on an evidence-based model of clinical prevention that focuses on specific diseases, well-defined preventive interventions, and evidence of improved health outcomes. Applying this model to prevention for very old patients has been problematic for several reasons: Many geriatric disorders have multiple risk factors, interventions, and expected outcomes; older adults are not often represented in clinical trials; and important outcomes may not be measured and reported in ways that are conducive to evidence synthesis and interpretation. In 2005, the USPSTF convened a geriatrics workgroup to refine USPSTF methodology and processes to better address the preventive needs of older adults. The USPSTF has begun to apply these new approaches to the review and recommendation on interventions to prevent falls in older adults.
美国预防服务工作组（USPSTF）的建议基于临床预防的循证模式，该模式侧重于特定疾病、明确的预防干预措施以及改善健康结果的证据。将该模型应用于非常老年患者的预防存在几个问题：许多老年疾病都有多个风险因素、干预措施和预期结果；老年人在临床试验中通常没有得到代表；重要的结果可能没有以有利于证据综合和解释的方式进行测量和报告。2005 年，USPSTF 召集了一个老年病工作组，以改进 USPSTF 的方法和流程，以更好地满足老年人的预防需求。USPSTF 已开始将这些新方法应用于评估和推荐预防老年人跌倒的干预措施。
