Screening of obesity
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
2017 USPSTF Guideline on the Screening of Obesity in Children and Adolescents 6 Years and older[1]
Recommendations for Screening of Obesity
| USPSTF Obesity Guidelines for Children and Adolescents 6 years and older |
| “1. The USPSTF recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status.(Recommendation Grade: B)” |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
USPSTF Grade Definitions [3]
Grade: A
- The USPSTF recommends the service.
- There is high certainty that the net benefit is substantial.
Grade: B
- The USPSTF recommends the service.
- There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.
Grade: C
- The USPSTF recommends against routinely providing the service.
- There may be considerations that support providing the service in an individual patient.
- There is moderate or high certainty that the net benefit is small.
Grade: D
- The USPSTF recommends against the service.
- There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.
Grade: I Statement
- The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service.
- Evidence is lacking, of poor quality or conflicting, and the balance of benefits and harms cannot be determined.
USPSTF Levels of Certainty Regarding Net Benefit [4]
Level of Certainty: High
The available evidence usually includes consistent results from well-designed, well-conducted studies in representative primary care populations. These studies assess the effects of the preventive service on health outcomes. This conclusion is therefore unlikely to be strongly affected by the results of future studies.
Level of Certainty: Moderate
- The available evidence is sufficient to determine the effects of the preventive service on health outcomes, but confidence in the estimate is constrained by factors such as:
- The number, size, or quality of individual studies
- Inconsistency of findings across individual studies
- Limited generalizability of findings to routine primary care practice
- Lack of coherence in the chain of evidence
- As more information becomes available, the magnitude or direction of the observed effect could change, and this change may be large enough to alter the conclusion.
Level of Certainty: Low
- The available evidence is insufficient to assess effects on health outcomes.
- Evidence is insufficient because of:
- The limited number or size of studies
- Important flaws in study design or methods
- Inconsistency of findings across individual studies
- Gaps in the chain of evidence
- Findings not generalizable to routine primary care practice
- A lack of information on important health outcomes
- More information may allow an estimation of effects on health outcomes.
U.S. Preventive Services Task Force Recommendation Grid [5]
| Certainty of Net Benefit | Magnitude of Net Benefit | |||
| Substantial | Moderate | Small | Zero/Negative | |
| High | A | B | C | D |
| Moderate | B | B | C | D |
| Low | Insufficient | |||
Resources
USPSTF Clinical Practice Guidelines
References
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society (DO NOT EDIT)[2]
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society (DO NOT EDIT)[2]
Identifying Patients Who Need to Lose Weight (BMI and Waist Circumference (DO NOT EDIT)
| Class I |
| “1. Measure height and weight and calculate BMI at annual visits or more frequently. (Level of Evidence: E)” |
| “2. Use the current cutpoints for overweight (BMI >25.0-29.9 kg/m2) to identify adults who may be at elevated risk of CVD and the current cut points for obesity (BMI≥30) to identify adults who may be at elevated risk of mortality from all causes. (Level of Evidence: A)” |
| “3. Advise overweight and obese adults that the greater the BMI, the greater the risk of CVD, type 2 diabetes, and all-cause mortality. (Level of Evidence: A)” |
| Class IIa |
| “1. Measure waist circumference at annual visits or more frequently in overweight and obese adults. Advise adults that the greater the waist circumference, the greater the risk of CVD, type 2 diabetes, and all-cause mortality. The cutpoints currently in common use (from either NIH/NHLBI or WHO/IDF) may continue to be used to identify patients who may be at increased risk until further evidence becomes available. (Level of Evidence: B)” |
2012 USPSTF Guideline on the Screening of Obesity in Adults[3]
Recommendations for Screening of Obesity in Adults
| USPSTF Obesity Guidelines for Adults |
| “1. The USPSTF recommends screening all adults for obesity. Clinicians should offer or refer patients with a body mass index (BMI) of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions.(Recommendation Grade: B)” |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
USPSTF Grade Definitions [3]
Grade: A
- The USPSTF recommends the service.
- There is high certainty that the net benefit is substantial.
Grade: B
- The USPSTF recommends the service.
- There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.
Grade: C
- The USPSTF recommends against routinely providing the service.
- There may be considerations that support providing the service in an individual patient.
- There is moderate or high certainty that the net benefit is small.
Grade: D
- The USPSTF recommends against the service.
- There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.
Grade: I Statement
- The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service.
- Evidence is lacking, of poor quality or conflicting, and the balance of benefits and harms cannot be determined.
USPSTF Levels of Certainty Regarding Net Benefit [4]
Level of Certainty: High
The available evidence usually includes consistent results from well-designed, well-conducted studies in representative primary care populations. These studies assess the effects of the preventive service on health outcomes. This conclusion is therefore unlikely to be strongly affected by the results of future studies.
Level of Certainty: Moderate
- The available evidence is sufficient to determine the effects of the preventive service on health outcomes, but confidence in the estimate is constrained by factors such as:
- The number, size, or quality of individual studies
- Inconsistency of findings across individual studies
- Limited generalizability of findings to routine primary care practice
- Lack of coherence in the chain of evidence
- As more information becomes available, the magnitude or direction of the observed effect could change, and this change may be large enough to alter the conclusion.
Level of Certainty: Low
- The available evidence is insufficient to assess effects on health outcomes.
- Evidence is insufficient because of:
- The limited number or size of studies
- Important flaws in study design or methods
- Inconsistency of findings across individual studies
- Gaps in the chain of evidence
- Findings not generalizable to routine primary care practice
- A lack of information on important health outcomes
- More information may allow an estimation of effects on health outcomes.
U.S. Preventive Services Task Force Recommendation Grid [5]
| Certainty of Net Benefit | Magnitude of Net Benefit | |||
| Substantial | Moderate | Small | Zero/Negative | |
| High | A | B | C | D |
| Moderate | B | B | C | D |
| Low | Insufficient | |||
Resources
USPSTF Clinical Practice Guidelines
References
References
References
- ↑ US Preventive Services Task Force. Grossman DC, Bibbins-Domingo K, Curry SJ, Barry MJ, Davidson KW; et al. (2017). “Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement”. JAMA. 317 (23): 2417–2426. doi:10.1001/jama.2017.6803. PMID 28632874.
- ↑ Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA; et al. (2013). “2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society”. Circulation. doi:10.1161/01.cir.0000437739.71477.ee. PMID 24222017.
- ↑ Moyer VA, U.S. Preventive Services Task Force (2012). “Screening for and management of obesity in adults: U.S. Preventive Services Task Force recommendation statement”. Ann Intern Med. 157 (5): 373–8. doi:10.7326/0003-4819-157-5-201209040-00475. PMID 22733087.
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