Citation

Grossman DC, Kemper AR. Pediatrics 2016; 137(2): 1-3.

Affiliation

Duke Clinical Research Institute and Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.

Copyright

(Copyright © 2016, American Academy of Pediatrics)

DOI

10.1542/peds.2015-3332

PMID

26759409

Abstract

Here is the question: Should a screening test that seems effective be adopted into routine practice with the expectation that evidence would eventually affirm its use or remove it from clinical care? Do we “do first, ask later?” We all know practices in our communities that still routinely use screening urinalyses out of concern about missing a “case” regardless of the potential harm and questionable benefit. How much do we need to know about a preventive screening test before it is recommended as “standard of care?” When do we know enough to either start or stop a service provided to all? How well do we stop a preventive service after it is shown to be ineffective?

Preventive care services delivery is the cornerstone of pediatrics. From the newborn visit through adolescence, the American Academy of Pediatrics (AAP) and Bright Futures recommend 31 well-child care visits, each with specific discrete preventive services. We are often asked by our trainees in clinic how we decide what services to provide within the limited available time. We were taught by skilled and talented clinicians based on their personal knowledge, experience, and expert opinion about what …

Language: en