Ch. 9 Screening Flashcards
What is the Primary objective of Screening?
Detection of a disease in its early stages in order to treat it and deter its progression
What is the secondary objective of screening?
to reduce the cost of disease management by avoiding costly interventions required at later stages
Define asymptomatic pathogenesis
latency; disease origin or development before symptoms first appear
Screening is what type of prevention?
Secondary
Advantages of Screening
- simple screenings can be preformed at home
- cost effective usually
- opportunity to educate those who may otherwise not get a change to get educated
define individual screening
-one person is tested by a health professional who has designated the individual at high risk
define group/mass screening
- a target population is selected on the basis of an increased incidence of a condition or recognized element of high risk within an identified group
- the target population may be invited to a central location at a designated time to be tested for the selected disorders
define multiple test screening
the administration of two or more tests to detect more than one disease
-in some cases one sample can be used to evaluate the possibility of sever conditions, saving time and money. Ex: Blood tests
What are the 5 A’s of Tobacco Cessations?
-recommended screening and counseling for successful tobacco intervention
Ask Advise Assess Assist Arrange
What are some Disadvantages of screening?
- margin of error (any margin of error could result in serious consequences)
- maybe it is not cost effective
- invasive
How is a Screening for a specific disease selected to be used?
-must also encompass emotional and financial impact of the disease detection on the population
- Does its significance warrant its consideration as a community problem?
- can the disease be detected by screening?
- should screening for the disease be done?
- what are the health benefits? can it be treated?
- what are the tangible and intangible costs?
define epidemiology
the study of the distribution and determinants of health related states in specified populations
The significance of a disease refers to what?
the level of priority assigned to the disease as a public health concern. significance generally is determined by incidence and prevalence and by the quantity and quality of life affected by the disorder
What may influence whether a disease should be screenable or not?
politics and special interest groups
morbidity
- to a diseased state or disability from any cause
- broader terms… a range or degree of the illness that affects the person
mortality
death
incidence
rate of occurrence , the rate of a new population problem and estimates the risk of an individual developing the specific disease or condition during a specific period or over a lifetime
prevalence
the proportion of a given population with the disease or condition at any one point in time. it provides the best estimate of whether a person is likely to become ill during a specific period of time.
usually chronic disease are measured by their….
prevalence (generally existing)
acute conditions are usually measured by their…
incidence (rate of occurrence)
quality of life
- subjective
- how do they perceive the disability of the disease, do they even see one at all?
QALY
- Quality Adjusted Life Year
- measurement of quality of health,
- utility value associated with a state of health by the years lived in that state of health
DALY
- Disability Adjusted Life Year
- it measure the burden of a disease
- accounts for life lost and life quality diminished through disability
Quantity of life
- severity of an incidence occurring
- cost associated with management
Why is testing for PKU at birth done with every single baby?
- it is extremely cost effective
- tested/detected within the first week of life there are things that can be done that make it treatable if detected now. if not the child will experience a lifetime of consequences and costs to manage
A screenable disease should have what type of diagnostic criteria?
- well diagnostic criteria
- defined normal parameters that are wholly accepted
Screening instruments should have what qualities?
- must be safe, cost effective, accurate
- reliability
- validity
reliability
-an assessment of the reproducibility of the test’s results when different individuals with the same level of skill perform the test during different periods and under different conditions
interobserver reliability
if the same result emerges when two individuals perform the test
intraobserver reliability
if the same individual is able to reproduce the results several times
what does it suggest if interobserver reliability of a screening instrument is low?
additional training might be required to work toward a more consistent method of test delivery
why would intraobserver reliability be necessary?
in substance abuse or mental health/depression screening
validity
reflects the accuracy or truthfulness of the test or instrument itself
false positive
individuals who do not have the disease but are referred for further tests because they test positive
false negative
- worse!
- those whose diseases where overlooked
- they lose the opportunity to receive early treatment that could prevent irreversible damage
Specificity
- measures the test’s ability to recognize negative reactions or non-diseased individuals
- excellent specificity = rare false positives
- poor specificity = more common false positive
Sensitivity
- refers to the proportion of people with a condition who correctly rest positive when screened
- good sensitivity = less false negatives
- poor sensitivity = lots of false negatives
What kind of community resources affect whether a disease is screenable?
-funds, workers, follow-through, treatment sources, administrative personnel
Lead Agency
overseas the development process of the community health program
- Vary : from community service organization to local public health department
- should partner with stakeholders (those who have legitimate interest in the topic)
key community individuals
considered leaders within the community
community assessment
- carried out by the members of the partnership
- systematic method of data collection that provides a detailed account, first identifying need and subsequently determining the type, quantity and quality of resources
