Preventing Disease, the offspring of an extraordinary collaboration between the U.S. and Canadian Preventive Services Task Forces, presents a meticulous and objective review of the published evidence on preventive measures. Examining such diverse and relevant topics as screening for endometrial cancer, exercise counselling for healthy adults, and the evidence for a causal relation between dietary lipids and coronary heart disease, this volume reflects the editors' shared conviction that recommendations for preventive action should rarely exceed what is well justified by the evidence. In the current period, characterized as the Second Public Health Revolution, the authors' hard-nosed approach leads them to ask the tough questions. Are preventive measures cost-saving? Does preventive screening actually lead to treatment in clinical practice? Does the treatment do more good than harm? To what extent does our desire to eliminate causes of serious disability, ill health and premature death cloud our objectivity? All concerned about preventive medicine, community health, and primary care will find valuable stimulation for thought and action in this book: the contributions have gone beyond the rhetoric.
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1 The Scientific Admissibility of Evidence on the Effectiveness of Preventive Interventions.- 2 Analytic Principles in Assessing the Effectiveness of Clinical Preventive Services.- Perinatal Medicine.- 3 Intrauterine Growth Retardation and the Routine Use of Serial Ultrasound.- 4 Intrapartum Electronic Fetal Heart Rate Monitoring: A Review of Current Status for the Task Force on the Periodic Health Examination.- Prevention in Childhood.- 5 Well-Baby Visits.- 6 Immunization, Immunoprophylaxis, and Chemoprophylaxis to Prevent Selected Infections.- 7 Preschool Screening: A Review of the Evidence.- Societal Problems.- 8 Physical Activity for Healthy Adults: Counseling as a Primary Preventive Intervention in Clinical Settings.- 9 Smoking Cessation: Attributes of Successful Interventions.- 10 Early Detection and Counseling of Problem Drinkers.- 11 Unwanted Teenage Pregnancy: A Canadian Perspective.- 12 Unwanted Teenage Pregnancy: A U.S. Perspective.- 13 Sexually Transmitted Diseases.- 14 Preventing Homicide.- 15 Early Detection of Depression.- 16 Suicide Prevention: A U.S. Perspective.- 17 Suicide Prevention: A Canadian Perspective.- 18 Detecting Cognitive Impairment in the Elderly.- 19 Bereavement: Health Consequences and Prevention Strategies.- 20 Automobile Injury: Selected Risk Factors and Prevention in the Health Care Setting.- 21 Falls in Older Persons: Etiology and Interventions.- Skeletal and Dental Disorders.- 22 Screening for Scoliosis: A Review of the Evidence.- 23 Preventing Low Back Pain.- 24 Postmenopausal Osteoporosis and Fractures.- 25 Preventive Dentistry.- Cancer.- 26 Does Screening for Breast Cancer Save Lives? Effectiveness of Treatment After Breast Cancer Detection Following Screening by Clinical Breast Examination, Mammography, and Breast Self-Examination.- 27 Lung Cancer.- 28 Dietary Fat and Cancers of the Breast, Colon, and Prostate: Evidence of a Causal Relation.- 29 Screening for Testicular Cancer.- 30 Occult Blood Testing for Colorectal Cancer.- 31 Screening Sigmoidoscopy for Colorectal Cancer.- 32 Screening for Cervical Cancer.- 33 Screening for Endometrial Cancer: Why It Is Premature to Recommend It.- Eye and Ear Disorders.- 34 Screening for Primary Open-Angle Glaucoma.- Chapte 35 Screening for Hearing Impairment.- Diabetes Mellitus.- 36 Screening for Diabetes Mellitus.- Urinary Tract Disorders.- 37 Hematuria and Proteinuria.- 38 Bacteriuria.- Cardiovascular Disease.- 39 Dietary Fat and Coronary Heart Disease: Evidence of a Causal Relation.- 40 Elevated Serum Cholesterol in Asymptomatic Adults.- 41 Mild Hypertension: Controversies in Management.- 42 Screening Electrocardiography in Asymptomatic Coronary Heart Disease.- 43 Asymptomatic Cervical Carotid Bruits.- Cost Effectiveness and Policy Issues in Implementation of Preventive Services.- 44 The Cost Effectiveness of Preventive Services: Some Examples.- Cost Effectiveness of Cholesterol Reduction for the Primary Prevention of Coronary Heart Disease in Men.- Cost Effectiveness of Cervical Cancer Screening Among Elderly Low-Income Women.- Cost Effectiveness of Isoniazid Chemoprophylaxis.- Conclusions.- 45 Technology Assessment and Prevention.- 46 Health Risk Assessment and the Clinical Practice of Preventive Medicine.- 47 Integration of Preventive Services Into Primary Care: A Conceptual Framework for Implementation.- 48 Educating and Counseling for Prevention: From Theory and Research to Principles.
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