Health Screening PDF

HEALTH SCREENING Casey Maidon, MMS, PA-C ME 617 Franklin Pierce University AGENDA USPSTF Shared Decision Making Screening Tools for Specific Diagnoses 2 INTRODUCTION In 1984, the Department of Health and Human Services established the U.S. Preventive Services Task Force (USPSTF) as an independent pa...

HEALTH SCREENING Casey Maidon, MMS, PA-C ME 617 Franklin Pierce University AGENDA USPSTF Shared Decision Making Screening Tools for Specific Diagnoses 2 INTRODUCTION In 1984, the Department of Health and Human Services established the U.S. Preventive Services Task Force (USPSTF) as an independent panel of nonfederal experts that would develop evidencebased recommendations on clinical preventive services based on systematic reviews of published research and explicit decision rules for translating science into practice policy. 3 USPSTF RECOMMENDATIONS 4 SHARED DECISION MAKING The Task Force defines shared decision making as a particular process of decision making by the patient and clinician in which the patient: 1. Understands the risk or seriousness of the disease or condition to be prevented. 2. Understands the preventive service, including the risks, benefits, alternatives, and uncertainties. 3. Has weighed his or her values regarding the potential benefits and harms associated with the service. 4. Has engaged in decision making at a level at which he or she desires and feels comfortable. 5 APPROACH TO SCREENING AND CHEMOPREVENTION Assess Assess patient's health needs: Acute issues. Eligibility for preventive services. Assess patient's desired role in decisionmaking. Advise Inform the patient about recommended preventive services (USPSTF A or B). If time permits, inform the patient about other services (USPSTF C, D, or I) with: High visibility. Special individual importance. If needed, provide balanced, evidence-based information about the service: Benefits. Harms. Alternatives. Scientific Uncertainties. If appropriate (A, B, D), make a recommendation. Agree Elicit patient's values and determine preferences. Negotiate a course of action. Assist Deliver or prescribe service. Arrange PRESENTATION TITLE Arrange followup or plan to revisit in the future. 6 CLINICIAN APPROACHES A 60 YR OLD MAN WITH DIABETES AND HYPERTENSION Assess Determine any acute issues Determine eligibility for preventive services Patient’s willingness for discussion Advise Inform patient Make recommendations Provide resources Agree Determine patient’s willingness Decide on course of action Assist Carry out the course of action Arrange Follow up 7 CHOOSING WISELY CAMPAIGN Founded in 2012 by ABIM Aimed at reducing unnecessary tests, procedures, and treatments Nearly all clinicians report ordering an unnecessary test or procedure at least once a week Driven by malpractice, patient requests, a desire for reassurance Increases health care costs and puts patients at risk for increased harm Showed a reduction in unnecessary tests and procedures, but we still have a long way to go! 8 ASCVD RISK ESTIMATOR Determines 10 year risk of developing atherosclerotic cardiovascular disease Calculator uses the following factors Age, Race, Gender, blood pressure, cholesterol, tobacco use, h/o diabetes, being treated for hypertension, being treated with a statin, being treated with aspirin Scan QR code to go to website for calculator 9 DIABETES SCREENING Increased risk for DM Impaired Fasting Glucose (IFG) or Impaired Glucose Tolerance (IGT) Prediabetic A1C 6.0-6.5% Diabetic A1C > 6.5% 10 METABOLIC SYNDROME National Cholesterol Education Program and Adult Treatment Panel III (NCEP-ATPIII 2001) defines as 3 or more of the following: Central obesity: waist circumference >102 cm (males), >88 cm (females) Hypertriglyceridemia: triglyceride level ≥150 mg/dL or specific medication Low HDLc cholesterol: