USPSTF releases the 14th Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services

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Over the course of the past 40 years, the U.S. Preventive Services Task Force (USPSTF or Task Force), an independent, volunteer panel of national experts in the fields of prevention, primary care and evidence-based medicine, has offered nearly 300 evidence-based recommendations meant to improve the quality of care provided to people of all ages. Recently, the organization released its 14th Annual Report to Congress, in which they commemorated the past 40 years with a continued focus on public health across the nation, specifically calling attention to key research gaps in seven of their recommendations from the past year.

The following areas are those identified by the USPSTF in their report as requiring future research to fill gaps which may result in new recommendations, thereby improving the health of patients nationwide:

Primary care interventions to prevent child maltreatment

The USPSTF called for additional research into their recommendation regarding primary care interventions to prevent child maltreatment. The organization believes more studies are required to provide primary care clinicians with a comprehensive understanding of child maltreatment, including possible red flags to look out for, benefits of intervention, intervention methods that effectively prevent child maltreatment and how social factors, race and ethnicity should impact their understanding of situations in order to reduce unintended risk, harm or bias.

Screening for speech and language delay and disorders in children

They also recognized the need for further research into the recommendation to screen children for speech and language delay and disorders. Specifically, they call for additional studies on the treatment of screen-detected children over short and longer periods of time to detect potential improvement in outcomes, like academic performance, social and emotional health or child and family well-being. They advise focusing on high-risk populations in these studies. Further, the Task Force calls for standardization of outcome measurements across studies and research into potential harms of screening and treatment, including possible stigma or anxieties. 

Interventions for high body mass index in children and adolescents

Regarding their recommendation for interventions when children and adolescents have high body mass index (BMI), the Task Force called for studies to determine how beneficial behavioral and pharmacotherapy interventions are after two years, as well as the long-term harms of behavioral interventions and pharmacotherapy, respectively. They would also like to establish best practices for both initial and ongoing weight-related discussions with children, adolescents and their families, in addition to the ideal timing for interventions regarding weight management, hoping to understand whether there are ideal ages throughout childhood and adolescents when interventions would provide the greatest benefit.

Screening and preventive interventions for oral health in children, adolescents and adults

The USPSTF advocated for screening and preventative interventions for oral health in children, adolescents and adults. They have now expressed their interest in additional studies which provide information on the effectiveness and potential downsides of primary care-based oral health screening strategies and oral health outcomes. Further, they want to know how accurate primary care-based oral examinations are in predicting and identifying oral health conditions in children, in addition to the effectiveness of various oral health preventive interventions and the impact that oral health education has on oral health outcomes.

Screening and supplementation for iron deficiency and iron deficiency anemia during pregnancy

The Task Force also expressed the need for additional research into their recommendation of screening and supplementation for iron deficiency anemia during pregnancy. Specifically, they’re curious whether changes in the mother’s iron status result in improved health outcomes for the mother or the infant in primary care settings. They also wish to fill gaps regarding the potential benefits and harms of screening for iron deficiency during pregnancy, routine iron supplementation in asymptomatic pregnant persons and treating for iron deficiency in asymptomatic, screen-detected populations. The USPSTF would also like to uncover any possible relationship between social determinants of health (SDOH) and risk factors for iron deficiency.

Screening for breast cancer

The organization also advocated for additional research into their recommendation that primary care clinicians screen for breast cancer. They would like to learn more about the benefits and harms of breast cancer screens in women age 75 and older. The group would also like to establish the best strategy for breast cancer screening in women found to have dense breasts on a screening mammogram, a common occurrence, as well as the benefits and harms of supplemental screening compared with supplemental care for women with dense breasts.

Regarding higher-risk populations, they called for additional research into why breast cancer mortality is higher among Black women, why Black women are more likely to be diagnosed with breast cancers that have biomarker patterns indicating poor health outcomes, how variations in care result in increased risk of breast cancer morbidity and mortality in Black women and whether benefits differ for annual vs biennial breast cancer screenings among women overall, when compared with Black women, specifically. More research is also advised regarding approaches to reduce the risk of overdiagnosis leading to overtreatment of breast lesions, which may not otherwise be as harmful, including ductal carcinoma in situ (DCIS), as well as further research into DCIS, and its potential to progress to invasive breast cancer.

Interventions for falls prevention in community-dwelling older adults

The USPSTF recommends that primary care clinicians talk with community-dwelling older adults for the purpose of preventing falls. They expressed the need for additional research into feasible risk assessment tools for accurate risk predictions for falls in community-dwelling adults over 65 years old. They would also like to compare the benefits and harms of interventions involving exercise, methods to potentially improve the availability of fall prevention interventions, the effectiveness and harms of interventions in different functional groups and the benefits and harms of interventions that are solely educational and psychological.

Moving into 2025

The Task Force concluded their report by discussing their plans over the coming year, which include developing and releasing new recommendation statements and coordinating with partners to develop and disseminate their new recommendations. Specifically, they shared their plans to continue work on 23 topics currently in progress, work on three topics from the public topic nomination process, post four draft research plans, eight draft recommendation statements with evidence reports for public comments and publish ten final and official recommendation statements. The organization will coordinate with the USPSTF Dissemination and Implementation Partners and Federal Liaisons to disseminate recommendations to primary care clinicians, continue work to address key research gaps and produce next year's 15th Annual Report to Congress.