Acta Medica Philippina最新文献

{"title":"Philippine Clinical Practice Guidelines for Periodic Health Examination: Screening for Hearing Disorders.","authors":"Ryner Jose D Carrillo, Abigail S Salcedo, Jose Leonard R Pascual V, Lina Rose A Alcances, Kathryn Baltazar-Braganza, Karl Jeffrey E Murillo, Marie Gene Cruz-Tantoco, Mark Dale S Imbag, Ma Theresa M Collante, Charlotte Averill Y Tan, Marquis Von Angelo Syquio Go Joson, Ma Kriselda P Alonzo, Larissa Christia F Adique, Abigael C Andal-Saniano, Jaymilyn V Catangay-Ombao, Maria Teresita S Cucueco, Joanne Sebastiana M De Ramos, Elmer M Dela Cruz, Jan Alexeis C Lacuata, Cindy Canceko-Llego, Kimberly Mae C Ong, Hubert D Ramos, Maria Rina T Reyes-Quintos, Rosario R Ricalde, Talitha Karisse L Yarza","doi":"10.47895/amp.v60i10.12730","DOIUrl":"10.47895/amp.v60i10.12730","url":null,"abstract":"<p><strong>Objective: </strong>These Philippine clinical practice guidelines (CPG) were developed to guide healthcare professionals on screening for hearing disorders among apparently healthy children and adult Filipinos.</p><p><strong>Methods: </strong>Following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended in the Department of Health Manual, the Task Force Steering Committee developed four key questions. The evidence review experts reviewed existing CPGs and appraised and summarized evidence. The multisectoral consensus panel reviewed the evidence summaries and developed recommendations during the <i>en banc</i> meeting. Three independent stakeholders reviewed the draft guidelines on the content, clarity, acceptability, applicability, and feasibility of the recommendations. Their feedback was taken into consideration by the steering committee before finalizing the CPG.</p><p><strong>Results: </strong>This CPG provides 10 recommendations based on four prioritized questions in the screening for hearing and vestibular disorders among apparently healthy children (from prenatal to school age) and adults.</p><p><strong>Conclusion: </strong>The consensus panel recommended the screening for hearing and vestibular disorders in certain population groups, based on the available evidence, the burden of disease, the cost of the confirmatory testing, and its applicability to the population.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"144-155"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2021 Clinical Practice Guidelines on Periodic Health Examination.","authors":"Ian Theodore G Cabaluna, Maria Vanessa V Sulit, Myzelle Anne J Infantado-Alejandro, Howell Henrian G Bayona, Leonila F Dans","doi":"10.47895/amp.v60i10.12061","DOIUrl":"10.47895/amp.v60i10.12061","url":null,"abstract":"<p><strong>Background and objective: </strong>The first Philippine Guidelines on Periodic Health Examination (PHEX) provided evidence-based recommendations for prevention strategies in the Philippines, published in 2004. This 2021 clinical practice guideline (CPG) on PHEX aimed to update the previous PHEX recommendations to align with the implementation of the Universal Health Care Act. This CPG aimed to guide primary care providers, specialists, patients, and the general public and provide recommendations for safe, accessible, and cost-effective screening practices.</p><p><strong>Methods: </strong>We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including the GRADE Adolopment and Evidence-to-Decision framework (EtD). A multisectoral panel developed the recommendations by a formal consensus method upon evaluation of the evidence on benefits and harms, cost-effectiveness, patient values and preferences, acceptability, feasibility, and impact on equity. A conflicts of interest (COI) committee reviewed, evaluated, and managed the potential or declared conflicts of interest of this CPG's Task Force members.</p><p><strong>Results: </strong>The 2020 PHEX CPG had 23 recommendation statements. Strong recommendations were made to screen for the following conditions 1) Hypertension, 2) Type 2 Diabetes Mellitus using fasting blood sugar, 3) Adult obesity using Body Mass Index (BMI), 4) Unhealthy alcohol use in adults, 5) Tobacco smoking, 6) Colorectal cancer, and 7) Cervical cancer.Weak recommendations were developed to screen for the following: 1) Lipid disorder among adults with cardiovascular risk factors, 2) Type 2 DM using HBA1C, 3) Acute malnutrition in children, 4) Unhealthy alcohol use in adolescents, 5) High-risk sexual behavior, 6) Depression, and 7) Pulmonary Tuberculosis using chest X-ray.On the other hand, strong recommendations were also made AGAINST screening for the following: 1) Developmental delay using developmental screening tools, 2) Coronary artery disease using ECG, and 3) Chronic Kidney Disease (CKD) using serum creatinine.Weak recommendations were also formulated AGAINST screening for the following: 1) Anemia using hemoglobin and/or hematocrit, 2) CKD using urinalysis, and 3) Lung cancer using chest X-ray.</p><p><strong>Conclusion: </strong>This guideline encourages adherence without restricting clinical judgment or patient-specific considerations. It also informs payers and policymakers without serving as the sole basis for financial or legal decisions. The strong recommendations in this CPG can be used as quality-of-care indicators when evaluating primary care programs. The recommendation statements will be updated at least every three years or as new evidence emerges.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"7-27"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Philippine Clinical Practice Guidelines for Periodic Health Examination: Immunization for Adults.","authors":"Armin N Masbang, Rosally P Zamora, Jane Eflyn L Lardizabal-Bunyi, Roberto A Razo, Rommel B Punongbayan, Howell Henrian G Bayona, Alrenzo Ludwig B Domingo","doi":"10.47895/amp.v60i10.12775","DOIUrl":"10.47895/amp.v60i10.12775","url":null,"abstract":"<p><strong>Background: </strong>Immunization is very important in public health because it reduces the spread of infectious diseases. It has been an essential part of health care programs as it prevents and controls a wide range of vaccine-preventable diseases worldwide.</p><p><strong>Objectives: </strong>The main objective of this Clinical Practice Guidelines (CPG) is to provide evidence-based recommendations on immunization for the prevention of vaccine-preventable diseases among apparently healthy adults and those with high-risk conditions.</p><p><strong>Methods: </strong>We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended in the Department of Health Manual, including GRADE Adolopment and the GRADE Evidence-to-Decision or EtD frame-work. This CPG contains the systematic synthesis of scientific evidence on immunization for Cholera, <i>Haemophilus influenzae</i> type b (Hib), Hepatitis A, Herpes Zoster, Human Papillomavirus (HPV), Influenza, Japanese Encephalitis, Measles, Meningococcal, Mpox, Pneumococcal, Rabies, Tetanus, Typhoid, and Varicella in the adult population.</p><p><strong>Results: </strong>The CPG provides forty-one (41) recommendations on prioritized questions regarding fifteen (15) vaccines.</p><p><strong>Conclusions: </strong>The systematic review of evidence was used to assess each vaccine's efficacy, safety, and costeffectiveness. These recommendations can be used by relevant stakeholders, particularly in the public health units, those in primary care practice and the administrative sectors involved in implementing vaccination programs.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"118-143"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Philippine Clinical Practice Guidelines for Periodic Health Examination: Screening for Congenital and Developmental Disorders.","authors":"Mary Ann R Abacan, Kathryn R Baltazar-Braganza, Ian Theodore G Cabaluna, Isabella S Ocampo","doi":"10.47895/amp.v60i10.10675","DOIUrl":"10.47895/amp.v60i10.10675","url":null,"abstract":"<p><strong>Background and objective: </strong>Congenital and developmental disorders should be detected early to avoid complications such as disability and death. The Philippine clinical practice guidelines (CPG) were developed to guide healthcare professionals on screening for congenital and developmental disorders among apparently healthy neonates and children.</p><p><strong>Methods: </strong>Following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended by the Department of Health (DOH), the steering committee, composed of clinical geneticists, developmental pediatricians, family and community medicine physicians, and ambulatory and community pediatricians, set the objectives of the CPG and formulated clinical questions in consultation with stakeholders. There were 15 priority guideline questions that covered various disorders including inborn errors of metabolism, critical congenital heart disease, developmental delay, learning disabilities, and autism. Evidence review experts systematically reviewed existing clinical practice guidelines, appraised, and summarized the evidence. A multisectoral panel formulated recommendations through a formal consensus based on the evidence summaries. The CPG was externally reviewed prior to publication.</p><p><strong>Results: </strong>The CPG provides twenty (20) recommendations on fifteen (15) prioritized questions in the screening for certain congenital and developmental disorders. This CPG contains recommendations for the screening for critical congenital heart disease, thalassemia, Glucose-6-phosphate dehydrogenase (G6PD) deficiency, developmental delay, and autism spectrum disorder. Recommendations against routine screening of cystic fibrosis, sickle cell disease, methionine adenosyltransferase deficiency, tyrosinemia, long chain 3-hydroxy acyl CoA dehydrogenase deficiency (LCHADD) and mitochondrial trifunctional protein deficiency (MTPD), carnitine palmitoyl transferase types 1 and 2 (CPT1, CPT2) and glutaric aciduria type 2 (GA2), biotidinase deficiency, beta-ketothiolase deficiency, holocarboxylase synthetase deficiency, and isovaleric acidemia were made.</p><p><strong>Conclusion: </strong>The consensus panel recommended the screening of certain conditions, based on the available evidence, the burden of disease, the cost of the confirmatory testing, and its applicability to the population. Although this CPG intends to influence the direction of health policies for the general population, it should not be the sole basis for recreating or abolishing practices that aim to improve the health conditions of many Filipinos, particularly those part of the workforce.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"28-41"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Philippine Clinical Practice Guidelines for Periodic Health Examination: Screening for Musculoskeletal Disorders.","authors":"Evelyn Osio-Salido, Nenacia Ranali Nirena P Mendoza, Bernadette Heizel M Reyes, Nathaniel S Orillaza, Carl Froilan D Leochico, Aldrich Ivan Lois D Burog, Howell Henrian G Bayona, Kerwyn Jim C Chan, Vaneza Leah A Espino, Mark David Dg Francisco, Myzelle Anne J Infantado-Alejandro, Rich Ericson C King, Cary Amiel G Villanueva, Mithi Kalayaan S Zamora, Isabel Teresa O Salido","doi":"10.47895/amp.v60i10.10951","DOIUrl":"10.47895/amp.v60i10.10951","url":null,"abstract":"<p><strong>Background and objective: </strong>Musculoskeletal diseases (MSDs) are acutely or chronically painful conditions that cause limitations in mobility, dexterity, and participation in society. They are a major contributor to years lived with disability worldwide and their burden is higher in countries with a lower sociodemographic index, like the Philippines. The goal of this clinical practice guideline (CPG) is to provide recommendations to primary care providers on screening for MSDs among asymptomatic, apparently healthy children and adults.</p><p><strong>Methods: </strong>Following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended in the Department of Health Manual, the evidence of net benefit or harm of screening for nine musculoskeletal conditions and risk factors was obtained through systematic literature search. Information on costeffectiveness, patient values and preferences, acceptability, feasibility of screening, and its impact on equity were also obtained. The final recommendations were formulated through consensus by a panel of representatives from multiple stakeholder groups.</p><p><strong>Results: </strong>There were 15 recommendations formulated. Strong recommendations were given to screen for physical inactivity among adults, fall risks and sarcopenia for adults aged ≥60 years old, and osteoporosis among women aged ≥65 years old. However, strong recommendations were made against screening for low vitamin D among infants, children, and adults, and against screening for osteoporosis among men and among women aged <65 years old.</p><p><strong>Conclusion: </strong>Through a comprehensive evaluation of the best available evidence using the GRADE approach, the Task Force developed 15 recommendations on screening and risk factor assessment for nine MSDs. These recommendations will serve as guidance on screening for MSDs at the primary care level.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"175-195"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Philippine Clinical Practice Guidelines for Periodic Health Examination: Screening for Mental Health and Addiction.","authors":"Shelley Ann F de la Vega, Marc Evans M Abat, Angely P Garcia, Belen M Dimatatac, Jose Paciano Baltazar T Reyes, Edwin M Fortuno","doi":"10.47895/amp.v60i10.11314","DOIUrl":"10.47895/amp.v60i10.11314","url":null,"abstract":"<p><strong>Background and objective: </strong>Screening for mental health and addiction disorders is a priority due to the rising prevalence of these conditions. This clinical practice guideline (CPG) sought to systematically synthesize evidence to address screening for mental health and addiction disorders among children, adolescents, and adults.</p><p><strong>Methods: </strong>This CPG followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended by the Department of Health, including GRADE Adolopment, a systematic process of adapting evidence summaries, and the GRADE Evidence to Decision (EtD) framework. The Steering Committee set the objectives, scope, target, and audience. The Steering Committee also led the formulation of clinical questions, and prioritized and finalized the questions after gathering inputs from relevant stakeholders. The Technical Working Group reviewed and synthesized the evidence, and a multisectoral Consensus Panel reviewed the evidence summaries and formulated recommendations through a formal consensus method, and the external reviewers evaluated the final recommendations. This CPG was completed in June 2022.</p><p><strong>Results: </strong>The CPG provides ten (10) recommendations on nine (9) prioritized questions on mental health and addiction. Screening for depression among high-risk groups, anxiety in adults, substance use disorders in adults and adolescents, depression and anxiety among children and adolescents, and stress and sleep disturbances as risk factors for possible mental health or addiction disorders were recommended. Recommendations were made AGAINST screening for dementia in older adults (60 and above) using standardized instruments and substance use disorders using standardized drug tests.</p><p><strong>Conclusion: </strong>The CPG provided recommendations on the prioritized clinical questions in the screening for certain conditions on mental health and addiction. The recommendations are based on the appraisal of the best available evidence.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"53-70"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Philippine Clinical Practice Guidelines for Periodic Health Examination: Screening for Renal, Metabolic, Nutritional, and Endocrine Disorders.","authors":"Elizabeth Paz-Pacheco, Raymond V Oliva, Cecilia S Acuin, Rey Jaime M Tan, Jim Paulo D Sarsagat","doi":"10.47895/amp.v60i10.11674","DOIUrl":"10.47895/amp.v60i10.11674","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Renal, metabolic, nutritional, and endocrine disorders significantly affect Filipinos due to the resulting mortality, cardiovascular outcomes, and negative impact on quality of life. Screening for these disorders may lead to earlier detection and management of the disease, with subsequent improvement of clinical outcomes if early therapeutic options are available. This must be balanced with potential harms resulting from mislabeling and the adverse effects of treatment. The objective of this clinical practice guideline (CPG) is to provide recommendations to optimize patient care on screening for renal, metabolic, nutritional, and endocrine disorders among asymptomatic, apparently healthy Filipinos.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended in the Department of Health Manual. The process included 1) generation of critical questions and critical outcomes, 2) retrieval of current evidence, 3) synthesis and assessment of the evidence base for these critical questions, 4) formulation of draft recommendations, 5) convening of a multisectoral stakeholder panel that evaluated the evidence base and considered feasibility, values, and preferences in formulating recommendations, and 6) planning for dissemination, implementation, impact evaluation, and updating. We performed a systematic synthesis of evidence to address screening for high climacteric syndrome, hypocalcemia or hypercalcemia, prediabetes, chronic kidney disease, hyperuricemia, malnutrition, nutritional anemia, among asymptomatic, apparently healthy adult Filipinos, and sexual maturity among asymptomatic, apparently healthy adolescent Filipinos.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After the presentation of the evidence synthesis and deliberation of the consensus panelists, this CPG provides 18 recommendation statements for the eight conditions. These statement recommendations serve as guides for the primary care physicians in their screening for the identified renal, metabolic, nutritional, and endocrine disorders. The CPG recommends AGAINST screening for high climacteric syndrome among asymptomatic, apparently healthy women aged 45-55 years using hormonal tests. Moreover, the guideline DOES NOT recommend the use of serum calcium, electrocardiogram, or bone mineral density in screening for hypocalcemia or hypercalcemia; estimated glomerular filtration rate, urine albumin concentration, urine albumin-creatinine ratio, and kidney ultrasonography in screening for chronic kidney disease; mid-upper arm circumference in screening for malnutrition; and, serum uric acid in screening for hyperuricemia for apparently healthy, asymptomatic adults. Routine assessment for sexual maturity among asymptomatic adolescents is also NOT recommended. However, the guideline recommends using fasting plasma glucose and hemoglobin A1C in screening for prediabe","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"196-209"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Philippine Clinical Practice Guidelines for Periodic Health Examination: Screening for Infectious Diseases.","authors":"Jemelyn U Garcia, Rosally P Zamora, Christopher G Manalo, Jennel Mae T Pimentel, Anna Sofia Victoria S Fajardo, Abigael Andal-Saniano, Diana A Payawal","doi":"10.47895/amp.v60i10.13376","DOIUrl":"10.47895/amp.v60i10.13376","url":null,"abstract":"<p><strong>Background: </strong>The persistent burden of communicable diseases, coupled with the risk of asymptomatic transmission, underscores the importance of a structured and evidence-based screening approach in the Philippines.</p><p><strong>Objective: </strong>This CPG provides evidence-based recommendations for the screening of asymptomatic, apparently healthy adolescent and adult Filipinos for infectious diseases and those with high-risk conditions.</p><p><strong>Methods: </strong>We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended in the Department of Health Manual, including GRADE Adolopment, a systematic process of adapting evidence summaries, and the GRADE Evidence to Decision (EtD) framework. The guideline development process had four general steps: 1) identification of priority research questions; 2) evidence synthesis and analysis; 3) formulation of the recommendations based on the balance of benefit, harm, values, and preferences; and 4) implementation and evaluation. The infectious diseases covered in this CPG are syphilis, chlamydia and gonorrhea, asymptomatic bacteriuria, Hepatitis A, Hepatitis C, HIV, dental infections, COVID-19, latent tuberculosis, and intestinal parasitism.</p><p><strong>Results: </strong>The task force developed 18 recommendations (10 strong recommendations, 8 weak recommendations) on screening asymptomatic, apparently healthy children and adults for infectious diseases.</p><p><strong>Conclusion: </strong>This Philippine Clinical Practice Guideline provides evidence-based recommendations for screening infectious diseases among asymptomatic, apparently healthy adolescent and adult Filipinos and those with high-risk conditions, emphasizing a risk-based rather than universal screening approach. The guideline highlights that targeted screening of high-risk populations for infections such as syphilis, HIV, hepatitis C, chlamydia/gonorrhea, and latent tuberculosis can improve early detection, reduce transmission, and prevent complications, while avoiding unnecessary costs and harms associated with indiscriminate screening. Overall, the recommendations reinforce the critical role of primary care and preventive health strategies in reducing the burden of infectious diseases in the Philippines.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"156-174"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Philippine Guidelines for Periodic Health Examination: Pediatric Immunization.","authors":"Marimel R Pagcatipunan, Natasha Ann R Esteban-Ipac, And Korina Ada D Tanyu","doi":"10.47895/amp.v60i10.11356","DOIUrl":"10.47895/amp.v60i10.11356","url":null,"abstract":"<p><strong>Background: </strong>Immunization is one of the most important public health achievements of the 20^th century, second only to clean water. Increased life expectancy from past decades, largely attributed to improved child survival rates and reduced child mortality from vaccine-preventable diseases, has shown that vaccines underpin disease prevention and control programs and are essential for global health security.</p><p><strong>Objective: </strong>This clinical practice guideline (CPG) provides evidence-based recommendations and best practices on immunization for the prevention of vaccine-preventable diseases, including those outside and within the scope of routine infant immunization provided by the National Immunization Program (NIP).</p><p><strong>Methods: </strong>We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended by the Department of Health Manual, including GRADE Adolopment and the GRADE Evidence to Decision or EtD framework. This CPG contains the systematic synthesis of scientific evidence on immunization for the pre-exposure prophylaxis of rabies infection, <i>Haemophilus influenzae</i> B booster, rotavirus, measles, mumps, varicella, BCG, tetanus booster, hepatitis B booster, pneumococcal conjugate vaccine (PCV), and pertussis booster in the pediatric population.</p><p><strong>Results: </strong>The CPG provides twelve (12) recommendations on prioritized questions regarding the relevant vaccines for preventing these eleven (11) disease conditions. Recommendations for rabies pre-exposure prophylaxis, <i>Haemophilus influenzae</i> B booster, rotavirus, measles, mumps, varicella, BCG, tetanus booster, Hepatitis B booster, pneumococcal conjugate vaccine, and pertussis booster vaccination were made.</p><p><strong>Conclusion: </strong>This CPG can be used to assess each vaccine's eligibility for inclusion in the NIP (rotavirus and varicella), support their continued use in existing immunization programs (<i>Haemophilus influenzae</i> B booster, measles, mumps, tetanus booster, PCV, and pertussis booster), and/or address controversy surrounding their use (preexposure prophylaxis for rabies and hepatitis B booster). Relevant stakeholders can use these recommendations to continuously improve the performance, reach, and efficacy of the National Immunization Program. These recommendations are intended for use in the Philippines only since vaccine access and epidemiologic conditions might vary in other countries and warrant different recommendations.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"107-117"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Philippine Clinical Practice Guidelines for Periodic Health Examination: Screening for Neoplastic Diseases.","authors":"Beatrice J Tiangco, Aldrich Ivan Lois D Burog, Ann Meredith Garcia-Trinidad, Mary Ondinee Manalo-Igot, Aldrin B Loyola, Roger N Velasco, Myzelle Anne J Infantado-Alejandro, Kenneth G Samala, Jezreline Marie I Cacanindin-Rimando, Howell Henrian G Bayona, Gina Antonina S Eubanas, Ma Pamela D Patdu","doi":"10.47895/amp.v60i10.13373","DOIUrl":"10.47895/amp.v60i10.13373","url":null,"abstract":"<p><strong>Background and objective: </strong>Cancer is among the leading causes of death in the Philippines, with an age-standardized mortality rate of 100 deaths per 100,000 persons. Despite the high incidence and mortality in the country, the Philippines has yet to implement a national early detection or screening program for cancers. The goal of these clinical practice guidelines (CPGs) is to provide evidence-based recommendations on screening for specific types of cancer: retinoblastoma, nasopharyngeal cancer, liver cancer, cervical cancer, oral cancer, colorectal cancer, breast cancer, prostate cancer, lung cancer, and gastric cancer.</p><p><strong>Methods: </strong>The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended in the Department of Health Manual was followed. There were 10 clinical questions covered in this CPG, of which 9 questions involved asymptomatic or apparently healthy adults, while 1 question involved early detection of retinoblastoma among children. The evidence of net benefit or harm of cancer screening was obtained through a systematic literature search from database inception up to August 2021. Additional information on cost-effectiveness, patient values and preferences, acceptability, feasibility of screening, and its impact on equity was also obtained. The final recommendations were made through consensus by a panel of representatives from multiple stakeholder groups.</p><p><strong>Results: </strong>There were 20 recommendations formulated. Strong recommendations were given to screen the following: patients at risk for hepatocellular carcinoma using ultrasound with alpha-fetoprotein (AFP); women aged 30 to 65 years for cervical cancer with cervical cytology alone, or high-risk Human papillomavirus (HPV) testing alone, or visual inspection with acetic acid as alternative to Pap smear; adults aged 35 and older who are smokers or alcohol drinkers for oral cancer using visual examination, and women 50 to 69 years for breast cancer using mammography and biennial clinical breast examination. However, strong recommendations were made AGAINST screening for cervical cancer among women aged 21 to 29 years, and AGAINST screening for cervical cancer with high-risk HPV testing in combination with cytology (co-testing).</p><p><strong>Conclusion: </strong>Through a comprehensive and systematic search of the best available evidence, the Neoplastic Diseases Task Force developed 20 recommendations on screening and risk factor assessment for 10 specific questions on neoplastic diseases. These recommendations serve as guidance on screening neoplastic diseases at the primary care level.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"90-106"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}