Family Physician Chairs U.S. Preventive Services Task Force

Dr. Alfred Berg, professor and chair of family medicine, chairs the influential U.S. Preventive Services Task Force, charged with evaluating the science behind preventive interventions and making public recommendations. In the past year, the Task Force came out with critical recommendations for aspirin use to prevent heart attacks as well as screening for breast cancer, colorectal cancer, newborn hearing loss, and depression.

Increasingly, instead of a definitive yes or no on specific interventions, many of the Task Force recommendations point toward shared decision-making between clinician and patient by weighing together the balance of benefits and risks in the individual case. To guide such discussions, the Task Force tries to lay out the options as clearly as possible.

“Patients need to know what they’re getting into with preventive interventions, many of which have some potential adverse effects,” said Berg. “The physician is saying to a healthy person: ‘If I do this, you’ll be better off.’ We think the evidence supporting that should be pretty strong.”

In the case of the breast cancer screening recommendation, for example, the Task Force found insufficient evidence to recommend for or against breast self-exams. Although the benefit of mammography was affirmed for women over 40, the balance of benefits and harms is less favorable at younger ages.

“No physician should just order any preventive intervention without a discussion,” said Berg. “The patient should be in on the decision.”

The Task Force urged colorectal cancer screening for all Americans over 50, recommended that physicians screen adults for depression, advised clinicians and patients to discuss aspirin therapy, and found insufficient evidence to recommend for or against routine screening of newborns for hearing loss.

Berg has chaired the Task Force since 1998.