Acta Medica Philippina最新文献

{"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}

{"title":"Philippine Clinical Practice Guidelines for Periodic Health Examination: Screening for Cardiovascular Disease.","authors":"Raymond V Oliva, Jose Donato A Magno, Deborah Ignacia David-Ona, John Dennis B Alcaraz, Jean D Alcover-Banal, Elmer Jasper B Llanes, Bevy Lynn Leaño, Noemi S Pestaño, Farrah Haidee Lynne D Pedracio, Jaime Alfonso M Aherrera, Elaine B Alajar, Mark A Vicente, Eddieson M Gonzales, Luigi Pierre S Segundo, Felix Eduardo R Punzalan","doi":"10.47895/amp.v60i10.11059","DOIUrl":"10.47895/amp.v60i10.11059","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Cardiovascular diseases remain to be the leading cause of death in the Philippines. Screening may lead to improvement of clinical outcomes if such conditions are detected and managed early and appropriately. The benefits of screening for a particular disease must be balanced with potential harms due to mislabeling or adverse effects of treatment, as well as socio-economic implications in the primary care setting. The main objective of this clinical practice guideline initiated by the Department of Health and the National Institutes of Health is to provide evidence-based recommendations that will help primary care physicians in detecting selected cardiovascular diseases among apparently healthy, asymptomatic individuals, while considering the socio-economic implications of the diagnostic screening tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a systematic synthesis of evidence to address screening for six priority cardiovascular conditions among asymptomatic, apparently healthy adult Filipinos: 1) familial hypercholesterolemia, 2) coronary artery disease, 3) asymptomatic carotid artery stenosis, 4) peripheral arterial disease, 5) abdominal aortic aneurysm, and 6) atrial fibrillation. We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended by the Department of Health. The process included 1) generation of critical questions and critical outcomes, 2) retrieval of current and relevant 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 to discuss feasibility, values, and preferences, and assess the strength of the recommendations, and 6) planning for dissemination, implementation, impact evaluation, and updating.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The CPG provides seven recommendations on six prioritized questions in the screening for certain cardiovascular disorders. After presentation of the evidence by the evidence reviewer experts and deliberation by the consensus panel, we came up with two statement recommendations for the question on screening for abdominal aortic aneurysm and one statement recommendation each for the rest of the clinical questions. The consensus panel made strong recommendations to screening for two conditions in asymptomatic and apparently healthy Filipinos, namely: familial hypercholesterolemia and abdominal aortic aneurysm (moderate).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Among asymptomatic, apparently healthy adult Filipinos, we recommend routine screening for two cardiovascular conditions: familial hypercholesterolemia and abdominal aortic aneurysm, with the latter being applicable only to men 60-80 years of age. These recommendations are offered to guide the primary care physician in screening key cardiovascular diseases and should not supplant but rather supplement the healthc","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"42-52"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358784","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: Lifestyle Interventions for Adults and Adolescents.","authors":"Diana R Tamondong-Lachica, Cary Amiel G Villanueva, Miriam Roxas-Timonera, Lia M Palileo-Villanueva","doi":"10.47895/amp.v60i10.13228","DOIUrl":"10.47895/amp.v60i10.13228","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Lifestyle has a considerable impact on the prevalence and prognosis of noncommunicable diseases, which continue to be the leading causes of morbidity and mortality in the country and around the world. Cardiovascular disease, cancer, chronic lung disease, and diabetes are universally recognized as being significantly related to modifiable behaviors such as tobacco smoking, physical inactivity, and poor diet. Alzheimer's disease, multiple sclerosis, depression, and anxiety disorders have also been linked to lifestyle factors. Interventions to encourage healthy lifestyles and discourage hazardous behaviors among individuals aim to lower the burden of noncommunicable illnesses, improve survival, and improve individuals' and communities' overall quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This Philippine clinical practice guideline (CPG) was developed to provide recommendations on nonpharmacologic approaches to promote healthy lifestyles among adults and adolescents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The Periodic Health Examination 2 (PHEX2) Lifestyle Advice Task Force proceeded through the preparation and prioritization, CPG generation, CPG appraisal, and implementation based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to CPG development recommended by the Department of Health (DOH). Nonpharmacological interventions of interest for this guide-line were &lt;i&gt;clinical interventions&lt;/i&gt; that pertain to strategies done or recommended by individual providers to patients, likely in a clinic setting. Evidence review experts systematically reviewed existing clinical practice guidelines, appraised, and summarized the evidence. For questions on specific advice on healthy diet and physical activity, the ADAPTE methodology was applied after appraising existing CPGs with the AGREE II instrument. A multisectoral panel formulated recommendations through a formal consensus based on the evidence summaries. The CPG was externally reviewed prior to publication. In addition to general questions on financial and intellectual conflicts of interest (COI), typically associated with the pharmaceutical industry, specific questions related to lifestyle, such as involvement with weight loss clinics or programs, wellness centers, tobacco, and e-cigarettes, were included.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nineteen (19) recommendations were made by the consensus panel, including adopting the WHO guidelines on physical activity and diet. During the consensus panel meetings, the impact of lifestyle-focused interventions on disease prevention was primarily considered, as well as the effect of these interventions on the prognosis of established diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The Philippine Guidelines on PHEX Phase 2 Lifestyle Advice CPG is a systematic synthesis of evidence to address lifestyle or nonpharmacologic interventions in preventing diseases and promoting better health. More evidenc","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"71-89"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358793","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 Prenatal Disorders.","authors":"Maria Julieta Corazon V Germar, Lia M Palileo-Villanueva, Sherri Ann L Suplido, Ma Susan B Villaluz, Mike Justin A Gianan, Endrik H Sy, Betha Fe M Castillo, Potre Mairasna P Boransing, Helen B De Peralta-Yambao, Maria Theresa G Cacas, John Jefferson V Besa, Ella Mae I Masamayor, Greco Mark B Malijan, Cary Amiel G Villanueva, Andrew Rufino C Villafuerte, Johannes Paolo B Cerrado, Marie Gene D Cruz, Lea Roselle O De Castro, Ma Sergia Fatima C Sucaldito, Alfonso Syoei R Yoshida, Lester Sam A Geroy, Elvie Udaundo Estrada, Daisy Evangeline C Garcia, Ferdinand B Sta Ana, Kristine Therese R Elises-Molon, Karla Kristine Silverio-Fernando, Clarissa L Velayo, Lara Marie David-Bustamante, Jo-Ann L Diosana, Maria Asuncion A Silvestre, Myzelle Anne J Infantado-Alejandro","doi":"10.47895/amp.v60i10.13595","DOIUrl":"10.47895/amp.v60i10.13595","url":null,"abstract":"<p><strong>Background: </strong>The Philippine Guidelines on Periodic Health Examination (PHEX) support the Universal Health Care Act by providing guidance on quality, accessible, and affordable screening services for Filipinos. Conditions that develop in the prenatal period are a major cause of neonatal deaths in the Philippines and account for 14% of deaths in children under five.</p><p><strong>Objectives: </strong>This guideline aims to provide evidence-based recommendations for screening prenatal disorders among asymptomatic, pregnant Filipino women. It also aims to equip general practitioners, obstetricsgynecology specialists, allied health professionals, patients, policymakers, regulatory agencies, and healthcare institutions with tools and guidance that facilitate informed, evidence-based healthcare decisions for pregnant women.</p><p><strong>Methods: </strong>The development of this CPG followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended in the Department of Health (DOH) Manual. Recommendations were finalized using the Evidence-to-Decision (EtD) framework. Evidence Review Experts conducted a systematic literature search and critically appraised recent local and international clinical guidelines. When necessary, they conducted <i>de novo</i> systematic reviews. Information on the benefits and harms of screening, cost-effectiveness, patient values and preferences, acceptability, feasibility, and its impact on equity was obtained. A multisectoral consensus panel reviewed the evidence and developed recommendations. A user-friendly web application and engagement with stakeholders for promotion and implementation were among the dissemination strategies. Experts conducted an external review to provide feedback on the methodology and recommendations.</p><p><strong>Results: </strong>Eleven recommendations for different screening strategies to improve the health outcomes of pregnant women and neonates were developed. This CPG contains recommendations for the screening for maternal thyroid disease, gestational diabetes mellitus, group B Streptococcus infection, fetal aneuploidy, risk for preeclampsia, iron deficiency anemia, and undernutrition, and conducting cervical length measurements, first-trimester ultrasound, and second-trimester ultrasound.</p><p><strong>Conclusion: </strong>This CPG provides 11 evidence-based recommendations. Applicability in the local setting was carefully considered through the involvement of different stakeholders. The recommendations herein shall hold until new evidence on screening, diagnosing, or managing various risk factors and diseases emerges, or contingencies dictate updating this CPG. This guideline will be updated after three (3) years.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"60 10","pages":"210-227"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358824","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}