Health Prevention definitions

Question 1

The goal of health prevention?

Answer 1

To avoid premature death

Question 2

What are the 4 types of health prevention strategies and describe them?

Answer 2

1. Primordial: preventing the development of risk factors. Upstream (eg. diet, physical activities, etc)
2. Primary: Reducing the risk of incidence of illness in patients with one or more risk factors. (E.g. Treating HTN)
3. Secondary: Avoiding recurrence of disease in pts already affected (chronic disease, flare ups) includes screening.
4. Tertiary: Require rapid action to prevent imminent death (eg. stent)

Question 3

Difference between prevention strategies and screening strategies?

Answer 3

Prevention = prevention of the development of risk factors
Screening = detecting evidence of disease at it’s an earlier stage when treatment is more likely to be effective. Can be performed in service for prevention.

Question 4

Overtesting?

Answer 4

When Dx tests or screening lack clear benefits or when the harms outweight the benefits.

Question 5

Overdiagnosis?

Answer 5

Dx that causes more harm than good to patients. Detecting and “abnormality” that would have not caused Sx or death and that would remain undetected. Because every treatment has side effects.

Question 6

Lead time bias?

Answer 6

Screening and Dx pt with a disease, but no available treatment can prevent death. So will die at the same time as if he was never Dx/treated.

Question 7

When do we engage in shared decision-making (SDM) in preventive health care?

Answer 7

When the recommendations in the guideline are conditional. No need to talk about it if the recommendation is STRONG.

Question 8

Examples (4) of conditional recommendations in favor of cancer screening intervention?

Answer 8

1. Breast: Mammography, 50-74 q 2-3y
2. Cervic: Pap, 25-29, q 3y
3. Colon: FIT, adults 50-59, q 2y
   Lung: LDCT, adults 55-74, q1x X 3 (with at least 30 pack-year, or quit less than 15 years ago)

Question 9

What are the 2 core elements of SDM?

Answer 9

1. Risk communication: harms vs benefits
2. Value clarification: What matters to the patients in terms of outcomes?

Question 10

Screening tests?

Answer 10

To detect potential disease indicators.

Question 11

Diagnostic tests?

Answer 11

To establish the presence or absence of disease.

Question 12

Case-finding?

Answer 12

A strategy for targeting resources at individuals or groups who are suspected of being at high risk of developing an illness. INvolves actively searching (Eg. communicable diseases)

Question 13

Opportunistic Screening

Answer 13

No formal register. Eg. Screening smoking status during primary care visits.