IMPORTANCE Overweight and obesity have been associated with adverse health effects. OBJECTIVE To systematically review evidence on benefits and harms of behavioral and pharmacotherapy weight loss and weight loss maintenance interventions in adults to inform the US Preventive Services Task Force.

Diet and physical activity behavioral interventions for adults not at high risk for cardiovascular disease result in consistent modest benefits across a variety of important intermediate health outcomes across 6 to 12 months, including blood pressure, low-density lipoprotein and total cholesterol levels, and adiposity, with evidence of a dose-response effect, with higher-intensity interventions conferring greater improvements. There is very limited evidence on longer-term intermediate and health outcomes or on harmful effects of these interventions.

IMPORTANCE Early identification of cognitive impairment may improve patient and caregiver health outcomes. OBJECTIVE To systematically review the test accuracy of cognitive screening instruments and benefits and harms of interventions to treat cognitive impairment in older adults (Ն65 years) to inform the US Preventive Services Task Force.

IMPORTANCE Cardiovascular disease is the leading cause of death in the US, and poor diet and lack of physical activity are major factors contributing to cardiovascular morbidity and mortality. OBJECTIVE To review the benefits and harms of behavioral counseling interventions to improve diet and physical activity in adults with cardiovascular risk factors.

Systematic reviewers should consider and be transparent when estimating data from figures when the information cannot be obtained from study authors and perform sensitivity analyses of pooled results to reduce bias.

Preeclampsia is a systemic hypertensive disorder in pregnancy that increases risks for serious maternal and neonatal health complications including eclamptic seizures, stroke, small for gestational age, intrauterine growth restriction (IUGR), preterm birth, placental abruption, and death. The incidence of preeclampsia in the United States was approximately 46.6 per 1000 deliveries in 2014, with a significant increase in preeclampsia with severe features in the decade preceding. In 2014, the US Preventive Services Task Force (USPSTF) recommended the use of low-dose (81 mg/d) aspirin after 12 weeks of gestation for asymptomatic pregnant women at high risk for preeclampsia. This analysis was conducted to update that recommendation based on new research since the previous USPSTF review.This analysis was framed with 3 key questions in mind to evaluate the efficacy of aspirin in reducing sequelae of preeclampsia: effectiveness of aspirin in reducing adverse maternal, perinatal, child, or combined health outcomes in pregnant persons at increased risk of preeclampsia; effectiveness of aspirin in preventing preeclampsia; and potential harms of aspirin use to prevent preeclampsia during pregnancy. Literature search was conducted from January 2013 to January 2021. To evaluate the benefits of aspirin, the analysis included randomized clinical trials and individual participant data meta-analyses among those at increased risk for preeclampsia, and to evaluate the harms of aspirin, eligible articles were expanded to include observational studies in lower-risk populations.A total of 23 studies met inclusion for this systematic review, with 18 evaluating pregnant individuals at increased risk of preeclampsia and 5 evaluating those at average risk. The timing of aspirin treatment varied significantly among included trials, ranging from initiation at 9 to 38 weeks and cessation from 34 weeks or when preeclampsia developed through delivery. Dosage ranged from 50 to 100 mg/d, with the majority using either 60 mg/d (6 trials) or 100 mg/d (9 trials). Pooled analysis revealed that when compared with placebo, aspirin use was significantly associated with a reduced risk of preeclampsia (relative risk [RR], 0.85; 95% confidence interval [CI], 0.75-0.95), perinatal mortality (RR, 0.79; 95% CI, 0.66-0.96), preterm birth (RR, 0.80; 95% CI, 0.67-0.95), and IUGR (RR, 0.82; 95% CI, 0.68-0.99). Aspirin initiation before 20 weeks' gestation was significantly associated with increased effectiveness for preventing preterm birth and small for gestational age/IUGR, and aspirin dosages greater than 75 mg/d were associated with increased effectiveness for prevention of preterm birth. No significant difference was observed in either postpartum hemorrhage (RR, 1.03; 95% CI, 0.94-1.12), placental abruption (RR, 1.15; 95% CI, 0.76-1.72), nor any other less commonly reported perinatal harms.The results of this systematic review found that low-dose aspirin is effective for preventing preeclampsia and related perinatal morbidity and mortality for individuals a...

IMPORTANCE Preeclampsia is a hypertensive disorder of pregnancy that poses serious maternal and infant health risks. Previous systematic reviews have established benefits of low-dose aspirin taken during pregnancy to prevent preeclampsia and its sequelae.OBJECTIVE To update evidence for the US Preventive Services Task Force (USPSTF) on effectiveness of aspirin use in preventing preeclampsia in individuals at increased risk based on clinical risk factors or measurements associated with higher disease incidence than in the general population.

There are insufficient adequately powered clinical trials evaluating the incremental effect of the ABI, hsCRP level, or CAC score in risk assessment and initiation of preventive therapy. Furthermore, the clinical meaning of improvements in measures of calibration, discrimination, and reclassification risk prediction studies is uncertain.