Clinicians should make shared decisions (pdf article) with patients about prevention interventions. These decisions are often more straightforward when excellent evidence is available, and more challenging when clear evidence is lacking. Each preventive service has its own effectiveness, benefits and risks, and evidence for or against its use. This is true of a risk assessment tool for mood disorders in the ambulatory setting; the accuracy of a clinical breast examination by physicians; the effectiveness of preventing influenza through vaccination; the risks of performing a colonoscopy; or the most successful manner to counsel teens to prevent sexually transmitted infections. The conclusions of a study may not be applicable if the study is not reflective of the patients in a given community. The outcome of tests shifts depending on the incidence or prevalence of disease in the community. When reviewing the quality of a study or of a particular guideline in prevention, it is helpful for physicians to develop their quantitative skills. In the next section we will briefly summarize important concepts that were covered in pre-clinical coursework (e.g., epidemiology) and see how these concepts apply to clinical preventive medicine.
This topic has the following sections:
- Measures of Burden of Disease in a Population
- Applying Quantitative Epidemiology to Preventive Services
- Measures of Association
- Critically Evaluating Guidelines and Recommendations
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