Health Promotion and Disease Prevention Flashcards
What are the four main preventative care services?
Immunizations
Screening
Behavioral Counseling
Chemoprevention
What are the three categories of prevention?
Primary, Secondary, and Tertiary prevention
In Primary Prevention do patients already have established disease?
No, patients do not have the disease yet. The goal is to prevent the disease from occurring (example: immunizations)
What is the goal of secondary prevention?
Patient already have the disease (usually early stage) or at high risk for disease and the goal is for early detection and cure, prevent disease progression
What are some examples of secondary prevention strategies?
HIV screening, insulin resistance
What is tertiary prevention?
Patient already has the disease and the goal is to prevent progression/deterioration (essentially treatment)
Can certain prevention screenings or interventions fall into several prevention strategy categories?
Yes, for example colonoscopy
What are the three things to considering what we should screen for?
- How great is the burden of the disease?
- How good is the screening test?
- How good is the treatment?
What are the D’s in burden of disease?
Death
Disease
Disability
Discomfort
Dissatisfaction
What is sensitivity?
Probability that a patient with the disease will have a positive test (true positive)
What is sensitivity actually telling you when the test comes back negative?
High sensitivity rules out if the result is negative (SNOUT)
What is specificity?
The probability that a patient without the disease will test negative
What is specificity actually telling you when the test comes back positive?
High specificity rules in if the result if positive (SPIN) - they probably have the disease
What is positive predictive value?
Likelihood that a person with a positive test has the disease, dependent on prevalence
What is negative predictive value?
Likelihood that a person with a negative test does not have the disease, dependent on prevalence
Is it easier to tell someone they don’t have disease (negative predictive value) or that they do (positive predictive value)?
That they don’t have a disease
What is the goal for screening tests?
Simplicity for the patient and cost
What is the number one harm of preventative care?
Dealing with false positive tests
What is lead time bias?
People who are diagnosed with screening survive longer after diagnosis that patients who present symptomatic, even if early treatment doesn’t make a difference
What is a way to avoid lead time bias?
Use mortality rates rather than survival rates
What is length time bias?
Comparing a short growing cancer to a fast growing
What is compliance bias?
Compliant patients have a better prognosis than non-compliant patients, regardless of screening
What is the difference between internal and external validity?
Internal validity are the results of the patients studied vs. external validity is how generalizable the results are to the patients not studied
What is the U.S. Preventative Services Task Force (USPSTF)?
An independent, volunteer panel of national experts in disease prevention and evidence-based medicine that make evidence-based recommendations about clinical preventitive services- goal is primary prevention
