final Flashcards
screening tests vs dx tests
screening: used to detect pathogens during sub-clinical stage
- from exposure to clinical signs
- early detection
- early treatment & ↑ prognosis
- focus: population level
dx: used to confirm or identify disease once clinical signs appear
- guide treatment & prognosis
focus: individual
measures of a test
validity: accuracy
reliability: repeatability
how do dx tests fx?
sense antibodies
false + vs false −
false positives can be caused by:
- similar disease agent ➞ confusion
- previous exposure
- lab/test error
- ensuring low false positives
- important for diseases w/ $$ tx or tx that cause suffering
false negatives can occur from:
- timing ➞ early in subclinical stage ➞ might not be long enough for immune system to begin response
- immunocompromised indiv don’t produce antibodies so tests cannot pickup
- ensuring low false negatives important for highly transmissible & severe diseases with extreme consequences
- ex: PRRS
proportion of the population diseased and exposed
proportion of the population exposed
proportion of the population diseased
true prevalence
actual level of disease prevalence in the pop
* cannot know ➞ estimate using AP
apparent prevalence
what prevalence appears to be based on the test
sensitivity
proportion of D+ that T+
* how accurate the test is at identifying diseased indiv
* ↑ Sn ➞ indiv that T+ are D+
specificity
proportion of D− that T−
* how good a test is at identifying non-diseased indiv
* ↑ Sp ➞ indiv that T− are D−
predictive value
probability of disease given the test result
positive predictive value (PPV)
probability/proportion of T+ that are D+
negative predictive value (NPV)
probability/proportion of T− that are D−
↑ prevalence =
↑ PPV & ↓ NPV
more dis in pop ➞ more indiv will T+ so less indiv will T−
↓ prevalence
↓ PPV & ↑ NPV
less dis in pop ➞ less indiv will T+ so more indiv will T−
AP < TP
underestimates TP of disease ➞ more false T− so D+ are missed
AP > TP
overestimates TP of disease ➞ more false T+ so D− animals are falsely dx
what measures do we use to quantify disease in populations?
- amount of dis
- morbidity: # of infxt - mortality: # of deaths from dis
- temporal distribution
- geographic/spatial distribution
- prevalence
- incidence
- cumulative incidence
- approximate incidence
prevalence
number of instances in a known pop at a specific point in time
* ** snapshot in time**
* diseases with long durations
* identifying common dis in pop
* evaluating control strategies
incidence
number of new cases in a known pop over a period of time
* preferred over prevalence
* dis w/ short durations
* understanding disease development and transmission (temporality)
* predicting risk of disease (change in health status)
cumulative incidence
proportion of non-dis animals at beginning of study that become dis during the study
* aka avg risk of developing disease during a time period
* who is getting diseased over time
* risk of disease
incidence rate
how quickly new cases develop over time
* closed pop only