If a service receives an I statement, what should clinicians do?

• A. Individualize decisions because evidence is insufficient to assess net benefit.
• B. Immediately implement the service for all adults.
• C. Discontinue research on the topic.
• D. Apply a blanket recommendation against the service.

Answer: (A)

This question tests what to do when the USPSTF assigns an I statement: the evidence is insufficient to assess the net benefit of a service. In this situation, clinicians should tailor decisions to the individual patient through shared decision-making, because there isn’t enough evidence to know whether the overall benefits outweigh harms for everyone. You should clearly discuss what is known about potential benefits and harms, the level of uncertainty, and the patient’s values and preferences, then choose an approach that fits that specific patient. This may mean offering the service if the patient values it and the potential benefits reasonably align with their risk, or opting against it if the uncertainties and risks outweigh the patient’s preferences. The key is not to apply a blanket recommendation or to discontinue research, but to personalize the decision based on the uncertain evidence.