Clinical Guidelines

Key Changes

• Aspirin — Now limited to those individuals whose benefits exceed harms. Explanation in text of how to calculate risk and harm values for each patient.
• Breast Cancer Mammography Screening —adopted USPSTF and American College of Physicians recommendations to screen ages 50 — 74 with mammography every 2 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms.
• HIV, Hep B, TB — references updated, risk groups spelled out in detail.
• Osteoporosis — Screen all women age = 65 and younger women whose FRAX score is 9.3% or higher (fracture risk of average 65 year old woman).
• Cervical Cancer Screening — every 2 years ages 21 — 29, every 3 years ages 30 - 64.
• Tdap Vaccine — Offer ONCE to all ages 7 and older in place of a routine tetanus booster. May give a month after receiving Td. No older age limit. Important especially to immunize caregivers of young children to reduce Pertussis epidemic.

Guidelines Resources

• Prevention Guidelines For Children and Adolescents (PDF)
• Guidelines for the Diagnosis and Management of Diabetes Mellitus in Adults (PDF)
• Introduction to the Revised Diabetes Guideline (PDF)
• Diabetes Mellitus Flow Sheet For Adults (PDF)

Questions or comments

Troy Kaji MD
CCHP Quality Department
595 Center Street, Suite 100
Martinez, CA 94553
email: tkaji@hsd.cccounty.us
voice mail: 925-370-5200 x3705