Parker Study Guide Pg 4 & 5

Question 1

20. High specificity can result in…?

Answer 1

Increase in false negatives

Question 2

20. High sensitivity can result in…?

Answer 2

Increase in false positives

Question 3

20. Is it preferable to have a screening test have higher sensitivity or higher specificity if a disease is serious but curable in the preclinical phase?

Answer 3

High sensitivity&raquo_space; specificity

Question 4

20. Is it typical for a screening test to have both high sensitivity and specificity?

Answer 4

Usually not common to have both - typically vice versa

Question 5

20. What is Positive Predictive Value (PPV)?

Answer 5

Proportion of people with a positive test who have the target disease (related to sensitivity)

Question 6

20. What is Negative Predictive Value (NPV)?

Answer 6

Proportion of people with a negative test who do not have the disease (related to specificity)

Question 7

20. Test A: Sensitivity 5%,
    Test B: Sensitivity 25%
    Test C: Sensitivity 80%

Which has the most false positives?

Answer 7

Test C (most sensitivity)

Question 8

20. Test A: Sensitivity 5%,
    Test B: Sensitivity 25%
    Test C: Sensitivity 80%

Which has the most false negatives?

Answer 8

Test A (least sensitivity)

Question 9

20. A researcher decides to use a low cutoff for diabetes testing in pregnant women (they want to catch more women). By lowering the cutoff has the sensitivity or specificity increased?

Answer 9

Sensitivity increases

Question 10

20. A researcher decides to use a low cutoff for diabetes testing in pregnant women (they want to catch more women). By lowering the cutoff should more false positives or false negatives be expected in the results?

Answer 10

More false positives (but they will probably not miss anyone who truly has gestational diabetes)

Question 11

21. What are the USPSTF levels of recommendation?

Answer 11

A - Recommend service (net benefit substantial)
B - Recommend service (moderate-substantial)
C - Recommend against routinely providing service (moderate-high of no net/harm outweighs risk)
D - Recommend against service (moderate-high harm outweigh benefit)
I - Insufficient evidence (if offered, patients should understand uncertainty about harms/benefits)

Question 12

22. What are the four different recommendations for Chlamydia from the USPSTF?

Answer 12

A: Sexually active non-pregnant women 24 or younger and older at risk
B: All pregnant women 24 and under and pregnant older women at risk
C: Routine screening of women 25+, pregnant or not, unless at risk
I: Routine screening of men

Question 13

23. Should we screen for:
    - Ovarian cancer?
    - Cervical cancer? When?
    - Breast cancer?

Answer 13

1. Ovarian - No
2. Cervical - Yes - at age 21
3. Breast - Yes

Question 14

23. Should we screen for:
    - Pancreatic cancer?
    - Colon cancer? When?
    - Oral cancer?
    - Skin cancer?

Answer 14

1. Pancreatic - No
2. Colon - Yes - at age 50
3. Oral - Yes
4. Skin - Y/N (Insufficient evidence for/against)