[The periodic health examination: a comparison of United States and Canadian recommendations].

OBJECTIVE To compare recommendations of the Canadian Task Force on Preventive Health Care with those of the United States Preventive Services Task Force for periodic health examinations (PHEs), following the usual sequence of a medical interview.

QUALITY OF EVIDENCE Each task force reviewed the literature exhaustively and created a system of classification that indicated the quality of the evidence.

MAIN MESSAGE Two tables sum up the conclusions of the task forces with respect to preventive measures to be included in PHEs: one for adults generally and one for women specifically. Three other tables show measures for which recommendations are different or conflicting, as well as measures that might be excluded. Several forms and other materials for PHEs based on these comparisons can be found at http://medecinefamiliale.com/umf/emc/emp_guide.htm. Many recommendations are similar; in spite of this, many physicians fail to include them in PHEs. Certain factors could explain the differences between the recommendations, including the challenge of arriving at a standard scientific process for reviewing data, the fact that formulating recommendations is a social as well as a scientific process, and the fact that the CTFPHC is seriously underfunded.

CONCLUSION A scientific review of the literature, even when performed by experts using strict criteria, is not easy to standardize. The differences that our comparison revealed, some of which are substantial, highlight the need to further examine how recommendations are formulated. More research in this field would be helpful.