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Clinician Article

Screening for Vitamin D Deficiency in Adults: US Preventive Services Task Force Recommendation Statement.



  • Krist AH
  • Davidson KW
  • Mangione CM
  • Cabana M
  • Caughey AB
  • Davis EM, et al.
JAMA. 2021 Apr 13;325(14):1436-1442. doi: 10.1001/jama.2021.3069. (Review)
PMID: 33847711
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Disciplines
  • Public Health
    Relevance - 6/7
    Newsworthiness - 7/7
  • Family Medicine (FM)/General Practice (GP)
    Relevance - 6/7
    Newsworthiness - 5/7
  • General Internal Medicine-Primary Care(US)
    Relevance - 6/7
    Newsworthiness - 5/7
  • Internal Medicine
    Relevance - 5/7
    Newsworthiness - 5/7

Abstract

Importance: Vitamin D is a fat-soluble vitamin that performs an important role in calcium homeostasis and bone metabolism and also affects many other cellular regulatory functions outside the skeletal system. Vitamin D requirements may vary by individual; thus, no one serum vitamin D level cutpoint defines deficiency, and no consensus exists regarding the precise serum levels of vitamin D that represent optimal health or sufficiency.

Objective: To update its 2014 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on screening for vitamin D deficiency, including the benefits and harms of screening and early treatment.

Population: Community-dwelling, nonpregnant adults who have no signs or symptoms of vitamin D deficiency or conditions for which vitamin D treatment is recommended.

Evidence Assessment: The USPSTF concludes that the overall evidence on the benefits of screening for vitamin D deficiency is lacking. Therefore, the balance of benefits and harms of screening for vitamin D deficiency in asymptomatic adults cannot be determined.

Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for vitamin D deficiency in asymptomatic adults. (I statement).


Clinical Comments

General Internal Medicine-Primary Care(US)

This review examines the role of screening Vitamin D levels in asymptomatic patients. They felt the evidence did not support screening because the blood tests for Vitamin D are not accurate, and the treatment in double-blind trials did not reduce mortality, fracture risk, or provide any medical benefit.

General Internal Medicine-Primary Care(US)

Every patient seen in our clinic is screened for Vit D level. Without exception, 95% or more are below recommended levels. NO ONE has symptoms. The cost of screening clearly outweighs the benefit of the test, which apparently is not helpful.....

Internal Medicine

Checking Vitamin D levels is widespread in my clinical environment and in the community. I have never found the evidence compelling, and it looks like USPSTF did not find it compelling either. Although the test is low cost, it would be great if this practice was reduced.

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