College of Nursing, The Ohio State University, Newton Hall, 1585 Neil Ave, Columbus, OH 43210, USA.
Pediatrics. 2012 Aug;130(2):e399-407. doi: 10.1542/peds.2011-2087. Epub 2012 Jul 2.
The development and use of evidence-based recommendations for preventive care by primary care providers caring for children is an ongoing challenge. This issue is further complicated by the fact that a higher proportion of recommendations by the US Preventive Services Task Force (USPSTF) for pediatric preventive services in comparison with adult services have insufficient evidence to recommend for or against the service. One important root cause for this problem is the relative lack of high quality screening and counseling studies in pediatric primary care settings. The paucity of studies limits the development of additional evidence-based guidelines to enhance best practices for pediatric and adolescent conditions. In this article, we describe the following: (1) evidence-based primary care preventive services as a strategy for addressing important pediatric morbidities, (2) the process of making evidence-based screening recommendations by the USPSTF, (3) the current library of USPSTF recommendations for children and adolescents, and (4) factors influencing the use of USPSTF recommendations and other evidence-based guidelines by clinicians. Strategies to accelerate the implementation of evidence-based services and areas of need for future research to fill key gaps in evidence-based recommendations and guidelines are highlighted.
为儿童提供初级保健服务的提供者制定并使用循证预防保健建议是一项持续存在的挑战。由于美国预防服务工作组(USPSTF)为儿科预防服务提供的建议比例高于成人服务,而这些建议的证据不足,因此无法推荐或反对该服务,这使得这一问题更加复杂。造成这一问题的一个重要根本原因是在儿科初级保健环境中缺乏高质量的筛查和咨询研究。研究的匮乏限制了制定更多循证指南的发展,以加强儿科和青少年疾病的最佳实践。在本文中,我们描述了以下内容:(1)循证初级保健预防服务是解决重要儿科疾病的策略,(2)USPSTF 制定循证筛查建议的过程,(3)USPSTF 目前针对儿童和青少年的建议库,以及(4)影响临床医生使用 USPSTF 建议和其他循证指南的因素。强调了加速实施循证服务的策略和未来研究的需求领域,以填补循证建议和指南中的关键空白。