There still isn’t enough evidence to say whether office- or home-based programs ordered by doctors actually prevent child abuse when obvious signs of maltreatment are absent, according to a government-backed panel.

The lack of a recommendation – known as an I statement, for “insufficient” – from the U.S. Preventive Services Task Force (USPSTF) echoes the same group’s 2004 conclusion, which also found a lack of evidence for or against child abuse prevention programs being applied to all kids, instead of just those clearly at risk.

“It is about interventions that can occur in the primary care office or can be referred by the doctor to someone in the community,” said Dr. David Grossman, a member of the panel and a senior investigator at the Group Health Research Institute in Seattle.

“It is disappointing because we had hopes that we could uncover evidence to convert it from an I statement to something more positive,” Grossman said.

Approximately 680,000 children younger than 18 years old were victims of maltreatment in 2011 and more than 1,500 died from it. That includes physical, sexual and psychological abuse.

The kids who survive abuse, according to the panel, are at increased risk for a number of troubles later in life, including psychological disorders and physical ailments, such as chronic pain and diabetes.

“Although we recognize the extreme importance of this issue and the protection of children should be paramount… The role of the primary care physicians in being the prevention, so to speak, is unclear because there is not enough evidence to say what doctors can do to prevent abuse in the first place,” Grossman told Reuters Health.

In January, the USPSTF published a draft of its findings, which are based on a review of 10 past studies of home-based interventions and one office-based program to reduce the number of related Child Protective Services (CPS) family reports and emergency room visits by kids