Table 2.
Priorities for Improving Utilization of Clinical Preventive Services
| Services (Short Name) | Description | CPB | CE | Total |
|---|---|---|---|---|
| Childhood immunization series | ACIP childhood immunization seriesa | 5 | 5 | 10 |
| Tobacco use, brief prevention counseling, youth | Provide interventions to prevent initiation, including education or brief counseling | 5 | 5 | 10 |
| Tobacco use screening and brief counseling, adults | Screen adults for tobacco use and provide brief cessation counseling and pharmacotherapy | 5 | 5 | 10 |
| Alcohol misuse screening and brief intervention | Screen adults’ misuse and provide brief counseling to reduce alcohol use | 3 | 5 | 8b |
| Aspirin chemoprevention for those at higher risk of CVD | Low-dose aspirin use for primary prevention of CVD in adults ages 50–59 y with ≤10%, 10-y CVD risk and other factors | 3 | 5 | 8 |
| Cervical cancer screening | Screen for cervical cancer in women aged 21 to 65 y with cytology (Papanicolaou smear) every 3 y | 4 | 4 | 8 |
| Colorectal cancer screening | Screen adults aged 50–75 y routinely | 4 | 4 | 8b |
| Chlamydia and gonorrhea screening | Screen for chlamydia and gonorrhea in sexually active women aged ≤24 y, and in older women at increased risk for infection | 3 | 4 | 7b |
| Cholesterol screening | Screen routinely for lipid disorders men aged >35 y, and screen younger men and women of all ages who are at increased risk of CHD. Treat with lipid-lowering medications | 4 | 3 | 7 |
| Hypertension screening | Measure blood pressure routinely in all adults and treat with antihypertensive medication to prevent the incidence of CVD | 4 | 3 | 7 |
| AAA screening | Screen men aged 65–75 y who have ever smoked 1 time for abdominal aortic aneurysm, using ultrasonography | 2 | 4 | 6b |
| Healthy diet and physical activity counseling for those at higher risk of CVD | Offer or refer adults who are overweight or obese with additional CVD risk factors to intensive behavioral counseling to promote healthful diet and physical activity | 5 | 1 | 6 |
| HIV screening | Screen for HIV infection in adolescents and adults aged 15 to 65 y. Frequency varies by risk level | 2 | 4 | 6b |
| HPV immunization | Administer a 3-dose series of HPV vaccine to all girls aged 11–12 y | 3 | 3 | 6 |
| Influenza immunization, adults | Immunize all adults against influenza annually | 4 | 2 | 6b |
| Obesity screening, adults | Screen all adults routinely for obesity. Refer patients with a BMI of ≥30 kg/m2 to intensive behavioral interventions | 5 | 1 | 6b |
| Syphilis screening | Screen all persons at increased risk for syphilis infection | 1 | 5 | 6 |
| Vision screening, children | Screen children routinely between ages 3 and 5 y to detect amblyopia | 2 | 4 | 6b |
| Breast cancer screening | Biennial mammography for women aged 50–74 y; screening before age 50 y an individual decision | 3 | 2 | 5b |
| Depression screening, adolescents | Screen adolescents aged 12–18 y for depression with systems to assure accurate diagnosis, treatment, and follow-up | 2 | 3 | 5b |
| Depression screening, adults | Screen adults for depression with systems to assure accurate diagnosis, treatment, and follow-up | 3 | 2 | 5b |
| Obesity screening, children and adolescents | Screen children aged ≥6 y for obesity. Offer or refer obese children to comprehensive, intensive behavioral intervention | 4 | 1 | 5 |
| Pneumococcal immunization, adults | Immunize adults aged >65 y against pneumococcal disease with PCV13 and PPSV23 | 2 | 3 | 5b |
| Herpes zoster immunization | Single dose of vaccine for adults aged >60 y | 1 | 3 | 4 |
| Osteoporosis screening | Screen women aged >65 y and younger women whose fracture risk is equal to or greater than that of white women aged 65 y with no additional risk factors | 2 | 2 | 4 |
| Folic acid chemoprevention | Women planning or capable of pregnancy should take a daily supplement with 0.4–0.8 mg of folic acid | 1 | 2 | 3 |
| Meningococcal immunization | Single dose of quadrivalent vaccine recommended for children aged 11 to 12 y, with a booster at age 16 y | 1 | 1 | 2 |
| Tdap/Td booster | One time Tdap and Td booster every 10 y | 1 | 1 | 2 |
AAA = abdominal aortic aneurysm; ACIP = Advisory Committee on Immunization Practices; BMI = body mass index; CE = cost-effectiveness; CHD = coronary heart disease; CPB = clinically preventable burden; CVD = cardiovascular disease; HIV = human immunodeficiency virus; HPV = human papillomavirus; PCV13 = pneumococcal conjugate vaccine—13 pneumococcal serotypes; PPSV23 = pneumococcal polysaccharide vaccine—23 pneumococcal serotypes; Td = tetanus, diphtheria; Tdap = tetanus, diphtheria, and pertussis.
Estimate includes all recommended vaccines up to 10 years of age (diphtheria, tetanus, pertussis; measles, mumps, rubella; inactivated polio virus; Hemophilus influenzae type b; hepatitis A; hepatitis B; varicella; pneumococcal conjugate; influenza; and rotavirus) plus influenza vaccination to age 18 years.
Sensitivity analysis indicated that a change of score of 2 or more is possible.