Ninth Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services

The U.S. Preventive Services Task Force (USPSTF or Task Force) has released its “Ninth Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services.”

In 2019, the USPSTF continued to fulfill its mission of improving the health of all Americans by making evidence-based recommendations about clinical preventive services such as screening tests, counseling about healthy behaviors, and preventive medications. These recommendations help clinicians and their patients make informed healthcare decisions.

In this annual report, the Task Force identified six high-priority topics affecting mental health, substance use, and violence prevention that need more research. Future research can help improve health and well-being and reduce illness and death.

Read the executive summary below or access the full report here (PDF File, 2 MB; PDF Help).

Executive Summary

The U.S. Preventive Services Task Force (USPSTF or Task Force) is an independent, volunteer panel of national experts in prevention, primary care, and evidence-based medicine. The Task Force makes evidence-based recommendations about clinical preventive services to improve the health of all Americans. The Task Force comprehensively assesses the potential benefits and harms of services to prevent disease in people without signs or symptoms, including screening tests, behavioral counseling, and preventive medications.

Each year, Congress charges the USPSTF to provide a report that identifies high-priority gaps in the scientific evidence base and recommends areas for future research. In some cases, clinical preventive services have been well studied for the general population, but there are important evidence gaps that prevent the USPSTF from making recommendations for specific population and age groups. In this ninth annual Report to Congress, which covers 2018 to 2019, the Task Force calls for more research in areas where evidence is lacking, including evidence for specific population or age groups.

Clinical Preventive Services for Which More Research Is Needed

Based on its recent recommendations, the USPSTF has identified six high-priority topics affecting mental health, substance use, and violence prevention that need more research. Mental illness, substance use, and violence affect the health and well-being of many Americans. They can increase the risk for other diseases, such as diabetes, heart disease, and cancer, as well as death. We need high-quality research to understand these complex health issues and how clinicians can meaningfully assist their patients in preventing them. This research can help improve health and well-being, and reduce illness and death. More specifically, more research is needed to:

Mental Health and Substance Use

  1. Perinatal Depression: Preventive Interventions
    • Identify who is at increased risk of perinatal depression
    • Determine ways to improve the delivery of perinatal interventions
  2. Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions
    • Assess effectiveness of screening for alcohol use in adolescents
    • Improve the delivery of alcohol use screening and counseling for adults
    • Examine whether different screening strategies for alcohol use are more effective in diverse populations
  3. Tobacco Use Prevention and Cessation in Children and Adolescents: Primary Care Interventions*
    • Identify effective ways to help youth quit using tobacco products
    • Evaluate interventions tailored specifically to prevent youth from starting to use and to help them quit using e-cigarettes
  4. Illicit Drug Use, Including Nonmedical Use of Prescription Drug Use in Adolescents and Adults: Screening by Asking About Drug Use*
    • Evaluate in adolescents the effectiveness of screening tools—which consist of asking questions about use—and interventions for illicit drug use
    • Identify the optimal interval to use screening tools—which ask questions about use—for detecting illicit drug use in adults
    • Assess accuracy of screening tools that ask questions to help detect nonmedical use of prescription drugs, including opioids

Violence Prevention

  1. Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: Screening
    • Evaluate screening for elder abuse and abuse of vulnerable adults
    • Assess screening and interventions for intimate partner violence in men
    • Determine the most effective components of ongoing support services
  2. Child Maltreatment: Interventions
    • Evaluate key outcomes consistently in studies, because using very different outcomes complicates a clear overall assessment of whether these interventions work
    • Include additional populations in studies (e.g., families with substance abuse in the home or limited access to social services)
    • Examine the extent and severity of unintended harms from risk assessment and preventive interventions

Future research in these areas can help fill these gaps and may result in important new recommendations that will help to improve the health of Americans. The USPSTF hopes that identifying evidence gaps and highlighting them as research priorities will inspire public and private researchers to collaborate and target their efforts to generate new knowledge and address important health issues.

*This draft recommendation statement is not yet final and was made available for public input. The final recommendation statement will be developed after careful consideration of the feedback received.

Current as of: November 2019


Internet Citation: Ninth Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services . U.S. Preventive Services Task Force. November 2019.