Lecture 6 Flashcards
screening is testing for health problems in the _______ of signs or symptoms that could indict the presence of the health problem
- absence
is screening a single test
- no; it is a cascade of events
screening procedures include
- asking questions
- performing the physical exam
- ordering lab tests
- imaging studies
screening is appropriate for diseases that are ________, have a _______ phase, and when ______ of testing and early treatment outweighs ________
- common
- detectable presymptomatic
- testing outweighs harms
the first step in the cascade
- screening test itself
positive screening means that a person is at a _______ risk for the disease
- higher risk
is a mammogram a screening test?
- yes
in most screening tests, there will be more ______ positives
- false positives
what ditzils or pseudodisease
- those with disease that is progressing so slowly that people would never have developed clinical symptoms in their lifetime
criteria for assuming that a screening test is appropriate for a patient
- disease to be screened for - substantial burden of suffering, common, pre-symptomatic phase
- treatment of disease - must work better if initiated in presymptomatic phase
- accuracy and acceptability of screening test
- test must not cause more harm than good
how can screening cause harm
- physical harm
- produces anxiety
- detects minimal abnormalities
- false negative tests
the strongest and most direct evidence about screening comes from
- randomized controlled trials
lead time bias
- a condition is found earlier by screening, but the actual time the person would have lived has not changed
- survival time longer but the person is not better off
length time bias
- the fact that cancers found by screening are slower growing and less malignant than cancers found by symptoms.
problems with a prostate test
- is it accurate enough for a population level
- does its use do more good than harm
