Approach To Basic Prevention

Question 1

Primary vs secondary vs tertiary prevention

Answer 1

Primary - prevention before exposure (so you don’t get exposed int he first place)
Secondary - early detection (so the disease doesn’t progress) and early intervention
Tertiary - After disease manifests (so the disease can reverse or go away hopefully)

Question 2

Screening is not always a good idea. There are three general criteria that make screening better than not screening. What are they?

Answer 2

Screening “saves lives” (won’t die)
It delays mortality or morbidity
It improves quality of life

Improves, delays or saves

Question 3

What are the three major criteria to consider when evaluating a screening test?

Answer 3

1. Characteristics of the Disease
2. Characteristics of the Population
3. Characteristics of the Test

Question 4

Three characteristics of the disease that we use to evaluate whether it is worth screening early for;

Answer 4

1. Disease causes significant morbidity or mortality (we don’t screen for warts)
2. There is a prolonged asymptomatic phase (you can see it on a screening test if there’s no symptoms)
3. Effective treatment is available (you can actually do something about it if you find it)

Question 5

What are the three characteristics of the population that would allow for a new screening test?

Answer 5

1. High prevalence (This has to exist/be prevalent amongst the population in question. If it barely occurs in this population, why screen for it?)
2. Acceptance of the test (Do people have a positive perception of it? Is there a general acceptance among the population that this is a good idea?)
3. Ability to comply/report (Are people going to actually do it?)

Question 6

To implement a new secondary screening protocol, what would the characteristics of the test need to be?

Answer 6

1. Sensitivity and Specificity (the test is accurate And yields accurate results).
2. Validity and reliability (the test is valid - it detects what it says it will. The test is reliable - if you test the same thing twice, you’ll get the same result. Equiptment, and reader, for example, must be reliable.
3. Cost effectiveness (Is the cost worth the result?)

Question 7

Lead time bias

Answer 7

You think someone has the disease and treat it and the patient lives longer w diagnosis, even though it may not have done anything.

Question 8

Length time bias

Answer 8

Detect slower growing tumors which may not have killed anyway. Don’t catch the fast ones (most likely).

Question 9

Compliance/adherence bias w/regards to screening

Answer 9

People who get screening are more likely to engage in other healthy activities and thus more likely to live longer.

Question 10

There are three types of bias that may show that screening helps people live longer and show early detection. What are they?

Answer 10

Lead time, length time, and compliance/adherence bias

Question 11

What is the choosing wisely campaign?

Answer 11

Items that encourage conversations aimed at reducing unnessecary tests and treatments throughout healthcare.

Question 12

From what type of study can you measure prevalence?

Answer 12

Cross-sectional

Question 13

Why can you measure incidence in a cohort study?

Answer 13

In a cohort study you start with a group exposed and unexposed and measure the disease that arises (incidence)