Politics in service of public health

Below is the text of a proposed resolution that will be submitted by the District of Columbia Academy of Family Physicians to next month's Congress of Delegates of the American Academy of Family Physicians in Orlando, Florida.

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WHEREAS family physicians rely on current, unbiased sources of evidence-based guidelines to select appropriate screening tests and counseling services for their patients;

WHEREAS the primary source of evidence-based prevention guidelines for family physicians is the federally-sponsored U.S. Preventive Services Task Force (USPSTF), whose recommendation statements commonly serve as the basis for AAFP clinical policies on preventive services;

WHEREAS the delay between the USPSTF vote on a new or updated recommendation statement and publication of the final statement is usually one year or more, and in some cases as long as three years;

WHEREAS the majority of existing USPSTF recommendations have not been updated within the past 5 years, and are considered out-of-date by the National Guideline Clearinghouse;

WHEREAS outdated USPSTF recommendation statements include those on breast cancer preventive medications, screening for ovarian cancer, screening for alcohol misuse, screening for family violence, counseling to prevent tobacco use in children and adolescents, and many other topics critical to the practice of family medicine;

WHEREAS political considerations recently resulted in the cancellation of the USPSTF’s November 2010 meeting and further delays in updating recommendations on screening for prostate and cervical cancer;

WHEREAS the USPSTF has only issued three updated recommendation statements since March of 2010;

NOW, THEREFORE, BE IT

RESOLVED, that the American Academy of Family Physicians request that the USPSTF and its sponsor, the U.S. Department of Health and Human Services, completely explain the reasons for recent delays in the recommendation development process and share its plans for reducing the proportion of outdated recommendations, AND BE IT FURTHER

RESOLVED, that the American Academy of Family Physicians consider developing an independent process for updating selected preventive care guidelines that are not being updated in a timely fashion (e.g., within a 5-year time frame) by the USPSTF.