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ACP Clinical Practice Guidelines

ACP Clinical Practice Guidelines cover many areas of internal medicine, ranging from screening to diagnosis and treatment of disease. The evidence-based guidelines provide recommendations to help clinicians deliver the best health care possible.

ACP High Value Care Advice focuses on high value care that assist physicians to provide the best possible care to their patients while simultaneously reducing unnecessary costs to the healthcare system.

Access ACP Guidelines from your smart phone or tablet. Download the ACP Clinical Guidelines app at itunes.com and android.com.

Upcoming Guidelines:

Evaluation of Patients with Suspected Acute Pulmonary Embolism: Best Practice Advice from the Clinical Guidelines Committee of the American College of Physicians - online publication in Annals of Internal Medicine on September 29, 2015.

Recent High Value Care Advice

Screening for Cancer: Advice for High-Value Care From the American College of Physicians

Published May 19, 2015 in Annals of Internal Medicine

Available from http://annals.org/article.aspx?articleid=2294149

High-value care advice 1: Clinicians should discuss the benefits and harms of screening mammography with average-risk women aged 40 to 49 years and order biennial mammography screening if an informed woman requests it.

High-value care advice 2: Clinicians should encourage biennial mammography screening in average-risk women aged 50 to 74 years.

High-value care advice 3: Clinicians should not screen average-risk women younger than 40 years or aged 75 years or older for breast cancer or screen women of any age with a life expectancy less than 10 years.

High-value care advice 4: Clinicians should not screen average-risk women of any age for breast cancer with MRI or tomosynthesis.

High-value care advice 5: Clinicians should not screen average-risk women younger than 21 years for cervical cancer.

High-value care advice 6: Clinicians should start screening average-risk women for cervical cancer at age 21 years once every 3 years with cytology (Papanicolaou [Pap] tests without HPV tests).

High-value care advice 7: Clinicians should not screen average-risk women for cervical cancer with cytology more often than once every 3 years.

High-value care advice 8: Clinicians may use a combination of Pap and HPV testing once every 5 years in average-risk women aged 30 years or older who prefer screening less often than every 3 years.

High-value care advice 9: Clinicians should not perform HPV testing in average-risk women younger than 30 years.

High-value care advice 10: Clinicians should stop screening average-risk women older than 65 years for cervical cancer who have had 3 consecutive negative cytology results or 2 consecutive negative cytology plus HPV test results within 10 years, with the most recent test done within 5 years.

High-value care advice 11: Clinicians should not screen average-risk women of any age who have had a hysterectomy with removal of the cervix for cervical cancer.

High-value care advice 12: Clinicians should not perform cervical cancer screening with a bimanual pelvic examination.

High-value care advice 13: Clinicians should encourage colorectal cancer screening by 1 of 4 strategies: high-sensitivity FOBT or FIT (every year); sigmoidoscopy (every 5 years); combined high-sensitivity FOBT or FIT (every 3 years) plus sigmoidoscopy (every 5 years); or optical colonoscopy (every 10 years) in average-risk adults aged 50 to 75 years.

High-value care advice 14: Clinicians should not screen for colorectal cancer more frequently than recommended in the 4 strategies mentioned previously.

High-value care advice 15: Clinicians should not conduct interval screening with fecal testing or flexible sigmoidoscopy in adults having 10-year screening colonoscopy.

High-value care advice 16: Clinicians should not screen for colorectal cancer in average-risk adults younger than 50 years or older than 75 years or those with an estimated life expectancy of less than 10 years.

High-value care advice 17: Clinicians should not screen average-risk women for ovarian cancer.

High-value care advice 18: Clinicians should have a 1-time discussion (more if the patient requests them) with average-risk men aged 50 to 69 years who inquire about PSA-based prostate cancer screening to inform them about the limited potential benefits and substantial harms of screening for prostate cancer using the PSA test.

High-value care advice 19: Clinicians should not screen for prostate cancer using the PSA test in average-risk men aged 50 to 69 years who have not had an informed discussion and do not express a clear preference for screening.

High-value care advice 20: Clinicians should not screen for prostate cancer using the PSA test in average-risk men younger than 50 years or older than 69 years or those with a life expectancy of less than 10 years.

Cardiac Screening With Electrocardiography, Stress Echocardiography, or Myocardial Perfusion Imaging: Advice for High-Value Care From the American College of Physicians

Published March 17, 2015 in Annals of Internal Medicine

Available from http://annals.org/article.aspx?articleid=2197181

High-value care advice: Clinicians should not screen for cardiac disease in asymptomatic, low-risk adults with resting or stress electrocardiography, stress echocardiography, or stress myocardial perfusion imaging.

Click here for more ACP guidelines.

Click here for ACP High Value Care Advice.

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