prevention Flashcards
example of a high risk strategy
pooled cohort equation
High risk strategy advantages
- Does not require social changes
- Allows for informed consent
- Patients receive individualized attention
High risk disadvantages
- Leaves social determinants unaddressed
- Potentially costly risk stratification required
- Access to high quality clinical services required
- Benefits depend on clinician and patient motivation
- Misses the majority of cases
low risk advantages
- Potential for widespread social benefits
2. No access to high quality clinical services required
low risk disadvantages
- May infringe on civil liberties
- Requires political consensus
- No informed consent
- No benefit to most individuals
Prevention Paradox:
A preventive intervention that brings much benefit to a population offers little benefit to each individual
secondary prevention
detection of the problem first and then testing/management
primary prevention
counseling (such as lifestyle)
- immunizations
- drug therapy
Take action to eliminate precipitating causes of disease and injury before they happen. Outcome is no health event.
primary prevention
Detect and treat asymptomatic disease, or its predisposition, before it becomes symptomatic or does irreversible harm. Outcome is no symptomatic disease.
secondary prevention
Minimize risk of recurrence or clinical deterioration once a disease is diagnosed.
Tertiary prevention
Infectious diseases and selected cancers Active or passive immunity Limited dosing Cost effective Rare adverse effects Dramatic history
immunizations
Diverse conditions Medications and dietary supplements Continuous dosing Cost effectiveness varies Common adverse effects Controversial history
chemopreventive agents
Probability that an individual with the disease will test positive =
a/(a+c).
sensitivity
Probability that an individual without the disease will test negative = d/(b+d)
specificity
Probability that an individual testing positive actually has the the disease = a/(a+b).
positive predictive value
Probability that an individual testing negative actually does not have the disease = d/(c+d).
negative predictive value
Test results with high _____ predictive values argue against the diagnosis and are rarely falsely negative.
negative
Test results with high _____ predictive values support the diagnosis and are rarely falsely positive.
positive
Highly specific tests have few _______ and are useful for confirming diagnoses with serious consequences.
false positives
Highly sensitive tests have few _________ and are useful for ruling out serious diseases that are not to be missed.
false negatives
what do we assume with all cancers?
they all behave the same
cancer screening disparities
breast vs prostate
