4 additional recommendation updates with no changes
Screening for high blood pressure in adults ages 18 years and older continues to receive an “A” recommendation.14 Importantly, the recommendation states that confirmation of high blood pressure should be made in an out-of-office setting before initiating treatment. Screening for vitamin D deficiency in adults and hearing loss in older adults both continue with “I” statements,15,16 and screening for asymptomatic carotid artery stenosis continues to receive a “D” recommendation.17 The implications of the vitamin D “I” statement were discussed in a previous Practice Alert.18
Continuing value of the USPSTF
The USPSTF continues to set the gold standard for assessment of preventive interventions, and its decisions affect first-dollar coverage by commercial health insurance. The reaffirmation of past recommendations demonstrates the value of adhering to rigorous evidence-based methods (if they are done correctly, they rarely must be markedly changed). And the updating of screening criteria shows the need to constantly review the evolving evidence for current recommendations. Once again, however, funding and staffing limitations allowed the USPSTF to assess only 1 new topic. A listing of all the 2021 recommendations is in TABLE 4.1