The information in the Red Book is organised into three levels. The first level is the lifecycle chart, which highlights when preventive activities should be performed and the optimum frequency for each activity. The lifecycle chart is organised by age and clinical topic. Simply check the column under a particular age group to see what activities should be considered for the patient. The preventive activities that are recommended for everyone within a particular age range, and for which there is sound research evidence, are shaded in red. Activities to be performed only in patients with risk factors or where the evidence is not as strong are shaded in light red or pink.
A copy of this chart can be downloaded and attached to the patient record as a systematic reminder for preventive activities. General practitioners (GPs) can also use it as a wall chart or keep it handy on the desk.
The second level is more detailed and presents a summary of recommendations in addition to tables that identify what preventive care should be provided for particular groups in the population. This edition of the Red Book adopts the existing National Health and Medical Research Council (NHMRC) levels of evidence and grades of recommendations.64 Future editions will consider adopting the GRADE system (www.gradeworkinggroup.org) for evaluating the quality of evidence for outcomes reported in systematic reviews.
Recommendations in the tables are graded according to the levels of evidence and strength of recommendation. The levels of evidence are coded by the roman numerals I–IV while the strength of recommendation is coded by the letters A–D. Practice Points are employed where no good evidence is available. Refer to Table IV.1 for more information.
Coding scheme used for levels of evidence and grades of recommendation64
Finally, there is a third level of information, which is on particular disadvantaged population groups that may be at risk of not receiving preventive care and what should be done to increase their chance of preventive care.