Prioritizing clinical preventive services: a review and framework with implications for community preventive services.

Setting priorities on the basis of factors such as health impact and economic value is the key first step to ensure that the most important services receive the most attention. Few prioritization efforts have been published that produce either rankings or information that can guide decision making. We propose a framework to help decision makers and clinicians balance short-term demands against long-term objectives. This framework provides guidance for decisions about scope, prioritization criteria, evidence review methods, evaluation of criteria fit, and presentation of results. The framework is the result of our experience setting priorities among clinical preventive services. It has not been tested in prioritizing community interventions and other health care services but should provide a useful starting point for designing priority-setting efforts in those areas.