Prepared for:

Agency for Healthcare Research and Quality

U.S. Department of Health and Human Services

540 Gaither Road

Rockville, MD 20850

http://www.ahrq.gov

Contract No. 290-97-0011

Task Order No. 3

Technical Support of the U.S. Preventive Services Task Force

Prepared by:

Research Triangle Institute-University of North Carolina Evidence-based Practice Center Research Triangle Park, North Carolina

Michael Pignone, MD, MPH *

Angela Fowler-Brown, MD *

Mark Pletcher, MD, MPH

Jeffrey A. Tice, MD

December 8, 2003

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

AHRQ is the lead Federal agency charged with supporting research designed to improve the quality of health care, reduce its cost, address patient safety and medical errors, and broaden access to essential services. AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access. The information helps health care decisionmakerspatients and clinicians, health system leaders, and policymakersmake more informed decisions and improve the quality of health care services.

The authors of this report are responsible for its content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services of a particular drug, device, test, treatment, or other clinical service.