Prevention and Screening- Moen Flashcards
What are the factors responsible for poor health?
-genetics
-environment (is a social factor)
-lifestyle
limited medical care (the answer is affordable healthcare)
What is the natural course of disease?
- Exposure
- Preclinical disease
- Clinical disease
- Complications
- Death
What are the levels of prevention?
- influenza vaccination: annually
- pneumococcal vaccination: after age 65
- tetanus vaccination: every 10 years
- chemoprophylaxis
- correct Identification of patient BEFORE providing medical care services
Health is not the absence of disease.
it is a privilege. You have to pay for it to get it. It is to keep your physical, emotional wellbeing.
What are the 3 correct Identification of patient BEFORE providing medical care services?
Name
Birthday
Social security
Level of Prevention
- hypertension screening
- coronary artery disease screening
- diabetes screening
- breast cancer screening (men are also at risk)
- colon cancer screening
What are at least two factors in evaluating prevention services?
- screening tests
- accuracy of tests
- effectiveness of early detection - immunization/chemoprophylaxis
- efficacy of vaccine/chemoprophylaxis
- effectiveness
VACCINE delays mortality more than preventing
You have to be precise with your questions to the patients.
??
What are the reasons for screening?
- to separate those most likely to have a disease from those least likely
- to exclude or confirm a diagnosis
What is the difference between incidence and prevalence?
all the new cases
incidence conveys information about the risk of contracting the disease, whereas prevalence indicates how widespread the disease is
HIV incidence rates have reduced because of screening and vaccinations
Where are places to screen?
- community
- prevalence survey - provider’s office
- health and risk assessment
- diagnostic testing - Hospital
- Work place
What are the appropriate reason for screening?
- disease must be serious (you don’t just do screenings—they COST; you do it when they are Asymptomatic)
- treatment before symptoms occur more beneficial
- High prevalence of preclinical disease
What is the acceptability of screening tests?
- affordable
- acceptable to the public
- conducted in confidence
- treatment for the disease
What are the evaluative criteria for screening tests?
- reliability
- accuracy
- yield
What is reliability?
-test performs consistently when given to individual under same conditions (not be being biased based on one pt dressed up nicely as opposed to another not dressed nicely)
reliability improves with standardization, training, and periodic checks
What are threats to reliability?
- variations inherent in subjects
- variations in method
- observer variation
test everything before you apply it
cannot have a questionnaire before administering
What is accuracy? What are its two components?
a test that measures what it is designed to measure; the probability of making a mistake is sooo minimal
Accuracy of a test has two components; it has to be:
- sensitive
- specific
What is the goal of screening? What is the purpose of medicine?
it is to reduce morbidity or mortality (extending the quality of life) from the disease by detecting diseases in their earliest stages, when treatment is usually more successful
to delay death is the purpose of medicine (medicine does not prevent death but offers you a chance to have a quality of life)
What does screening mean?
- refers to the application of a medical procedure or test to people who as yet have no symptoms of a particular disease
- the purpose of which is determining their likelihood of having the disease
- screening procedure itself DOES NOT DIAGNOSE the illness
- those who have a positive result from the screening test will need further evaluation with subsequent diagnostic test or procedure
What are some examples of screenings?
pap smear, mammogram, clinical breast exam, blood pressure determination, cholesterol level, eye examination/vision test, and urinalysis.
What is sensitivity?
sensitivity refers to a test’s ability to designate an individual with disease as POSITIVE
refers to a tests ability to CORRECTLY classify a person as having a disease or not having a disease
-has very few false negative results, thus fewer cases of disease are missed
How is specificity different from sensitivity?
specificity of a test is its ability to designate the individual who does not have a disease as NEGATIVE
What is predictive value?
the probability of having the disease, given the results of a test
It is an ANSWER to the question.
How is the predictive value determined?
-determined by the sensitivity and specificity of the test and the PREVALENCE of disease in the population being tested
What criteria should be considered for an effective screening program?
- life-threatening diseases, such as those as breast cancer, and those known to have serious and irreversible consequences if not treated early such as congenital hypothyroidism, are appropriate for screening
- treatment of disease at their earlier stages should be more effective than treatment begun after the development of symptoms
- the prevalence of the detectable preclinical phase of disease has to be high among the population screened
Treatment is more effective during the screening stage than when the cancer has become invasive.
On the other hand, lung cancer has a poor prognosis regardless of the stage at which treatment is initiated.
Early diagnosis and treatment appear to prolong life little more than therapy after symptoms have developed.
Screening to detect early stage lung cancer using currently available techniques would not be beneficial.
The definition of cancer has changed overtime.
A suitable screening test must be available. Suitability criteria includes what?
-includes adequate sensitivity and specificity, low cost, ease of administration
What is true positive ?
sensitivity
a/[a+c]
What is true negative ?
specificity
d/[b+d]
What is false positive?
Disease/condition is absent but test is positive
What is false negative?
disease condition is present but test is negative
Again what is the difference between sensitivity and specificity?
sensitivity is the ability of a test to detect the disease/condition when it is truly present
specificity is the ability of a test to exclude the disease/condition in patient who do not have the disease/condition
What are the 3 factors for measuring sensitivity?
- independent variable
- dependent variable
- interactions of sensitivity, specificity, and predictive values
What is number needed to screen (yield)?
is a measure of how many individuals need to be screened to find a true positive results
What is number needed to treat (yield)?
is a measure of how many individuals must be treated to achieve a desired outcome
