Screening for and Management of Obesity in Adults: U.S. Preventive Services Task Force Recommendation Statement: A Policy Review
Bibliographic record
Abstract
RationaleThe USPSTF previously provided guidelines for the screening of obesity in adults in their 2003 recommendations.8 The Centre for Disease Control's Healthy People 2010 objectives were originally defined in 2001.However, the 2011 Final Review of these objectives reported that almost no progress had been made towards the focus area of nutrition and obesity in the last decade.Obesity levels remain in excess of 30% of the population in the USA, 9 despite aims to reduce these levels to less than 15%.10 Obesity has been associated with numerous adverse health effects including increased mortality from ischaemic heart disease, diabetes, respiratory disease, and certain types of cancer.11 The management of these co-morbidities also poses a considerable economic burden.12 The USPSTF 2012 recommendations for screening and management of obesity in adults represent an update on the 2003 recommendation statement based on the most recent evidence base. 1 Method The 2012 update focuses on non-surgical interventions.Two independent investigators appraised 6498 abstracts and 648 articles from searches of MEDLINE, Cochrane Central Register, and PsycINFO databases from January 2005 to September 2010.NICE systematic reviews on behavioural interventions and weight loss (2006), and metformin (2008) were relied on to cover the search window from the previous USPSTF 2003 guideline and the current review.Thirty three new trials of behaviour interventions were identified, 16 involving orlistat plus behavioural interventions, and three involving metformin plus behavioural interventions (a total of 27,403 participants).11 However, no new trials were identified comparing screening for obesity in adults with no screening.In addition, many studies could not be pooled due to insufficient reporting of variance data.13 RecommendationsTwo main recommendations were made based on the findings.First, it is recommended that clinicians should screen
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".