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Preventive services listed in each section are not necessarily recommended with the same periodicity. For example, fecal occult blood testing and/or sigmoidoscopy are recommended for all patients aged > 50 years. However, the periodicity for each service is not the same. Fecal occult blood testing is recommended yearly, whereas sigmoidoscopy is recommended every 2 to 3 years.

Although the preventive services can serve as a framework for periodic checkups devoted entirely to health promotion and disease prevention, they may also be indicated during visits for other reasons (e.g. acute illness, chronic disease checkups). Indeed, health maintenance must be considered at every visit. It is recognized that busy clinicians may not be able to perform all preventive services indicated for a particular patient during a single clinical encounter. However, recommended preventive services that cannot be performed by the clinician during a single visit should be scheduled for a later health visit.

Immunizations included are those recommended on a routine basis and do not apply to persons with special exposures to infected individuals. The chapters do not include interventions for which the Task Force found insufficient evidence on which to base recommendations. The final version of the Guide to Clinical Preventive Services was available March 1, 1996. Interventions that have proven themselves to be effective since this date are thus not included. The editor notes the new literature on PSA screening that has come out since March 1996 as an area where an informed clinician may need to reevaluate his or her policies.

The population guidelines contained in this book are not a substitute for sound clinical judgment regarding the needs of an individual patient. Nonetheless, the recommendations made by the Task Force do set a basic standard for effective preventive health care.

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