Lecture 7B Flashcards
What is the difference between the population strategy and the high risk strategy?
Population strategy tries to move whole population back eg smoking cessation adverts while high risk strategy only targets those at high risk of developing the disease. Eg statins to those with coronary heart disease
Why do we focus on cure rather than prevention?
Because a pill a day is easier than an hours exercise per day. Some patients with poor diets would ask “why cant i eat bad and just take statins?”
Why is prevention between than cure?
It is much more effective. It is much cheaper and once you have a disease or condition you never truly return to “normal”
What are the levels of prevention?
Primordial, primary, secondary and tertiary
What is primordial prevention?
Eliminate all risk factors associated with a disease. Done at population level.
Eg ban sugar imports for obesity
What is primary prevention?
Concerned with preventing any pathological changes before they arise.
Eg sugar tax for obesity
What is secondary prevention?
Detecting a disease in its earliest stages before it is symptomatic and slowing or stopping its progression.
Eg screening people with a high BMI for type two diabetes
What is tertiary prevention?
Any steps taken after symptoms occur including treatments, drugs and steps to minimise suffering.
Eg diabetic drugs and foot checks
What is the difference between a disability, impairment and handicap?
Impairment= any loss or abnormality of psychological, physiological or anatomical structure and function
Disability= restriction or inability to perform an activity in the range considered normal for a human
Handicap= disadvantage for a given individual that prevents them operating at a level that is normal for that individual
None necessarily leads to the other
What is the difference between a diagnostic test and a screening test?
Diagnostic test is definitive while a screening test only tells you if you are at high risk or low risk of getting the disease
What is a positive and negative predictive value?
Positive predictive value= tells you if you are high risk how likely you are to actually have the disease (percentage of positive test that become cases)
TP divided by TP+FP
Negative predictive value= if you are low risk how likely is it that you do not have the disease (percentage of negative tests who are not cases)
TN divided by TN + FN
What is sensitivity?
proportion of cases which the test correctly detects
TP divided by TP+FN
What is specificity?
Proportion of non cases for which the test correctly detects
TN divided by TN+FP
What is the acronym used to remember what screening effectiveness tool goes with which?
“Sensitivity to peoples feelings when they have a disease is a positive thing”
Sensitivity= disease= positive predictive value
Specificity= no disease= negative predictive value
What are the effects of screening high prevalence populations?
PPV will increase and negative predictive value will fall but only slightly
