Structured Abstract

Contents

• 1. Introduction
  • Scope and Purpose
  • Background
  • Previous USPSTF Recommendation
• 2. Methods
  • Key Questions and Analytic Framework
  • Data Sources and Searches
  • Study Selection
  • Quality Assessment
  • Data Extraction
  • Data Synthesis and Analysis
  • USPSTF Involvement
• 3. Results
  • Literature Search
  • KQ 1 What Is the Efficacy of Multivitamin Supplement Use on Health Outcomes in the General Adult Population?
  • KQ 2 What Is Known About the Safety of Multivitamin Supplement Use in the General Adult Population?
  • KQ 3 What Is the Efficacy of Supplementation With Single Nutrients or Functionally Related Nutrient Pairs on Health Outcomes in the General Adult Population?
  • KQ 4 What Is Known About the Safety of Single Nutrient Use in the General Adult Population?
• 4. Discussion
  • Summary of Evidence
  • Limitations in the Body of Evidence
  • Limitations in Our Approach
  • Applicability
  • Future Research
  • Conclusions
• References
• Appendix A Dietary Reference Intakes
• Appendix B Detailed Methods
• Appendix C Ongoing or Recently Completed Studies
• Appendix D Excluded Studies
• Appendix E Evidence Tables
• Appendix F Outcomes Reported by Original Randomized Arms Among the 2×2 Factorial-Designed Randomized, Controlled Trials
• Appendix G Additional Meta-Analysis Figures
• Appendix H Sensitivity Analysis: Random vs. Fixed Effects Models

Note: A journal article associated with this work was published in Annals of Internal Medicine. At the request of the journal, we featured fixed effects models for pooled outcomes reported in the manuscript. The fixed effects models produced very small changes compared with the random effects models and do not change the overall findings of the report. Appendix H provides a comparison between the fixed effects and random effects model results for selected outcomes.

Acknowledgments: The authors gratefully acknowledge the following individuals for their contributions to this project: Robert McNellis, MPH, PA-C, at AHRQ; Virginia Moyer, MD, MPH, Michael LeFevre, MD, MSPH, and Wanda Nicholson, MD, MPH, MBA, of the U.S. Preventive Services Task Force; JoAnn Manson, MD, DrPH, MPH, Thomas Trikalinos, MD, PhD, and Janelle Peralez-Gunn, MPH, for providing expert review; and Carin M. Olson, MD, MS, Daphne Plaut, MLS, and Heather Baird at the Kaiser Permanente Center for Health Research.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. HHSA 290-2007-10057-I. Prepared by: Kaiser Permanente Research Affiliates Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, OR

Suggested citation:

Fortmann SP, Burda BU, Senger CA, Lin J, Beil T, O'Connor E, Whitlock EP. Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Evidence Report No. 108. AHRQ Publication No. 14-05199-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; 2013.

This report is based on research conducted by the Kaiser Permanente Research Affiliates Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA 290-2007-10057-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information; that is, in the context of available resources and circumstances presented by individual patients.

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

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