Prevention / Screening

Question 1

What is primary prevention in medicine?

Answer 1

Healthy individuals preventing from getting a disease, such as balanced diet, not smoking, ideal body weight

Question 2

What is secondary prevention?

Answer 2

Detecting early disease to prevent its progression and reduce morbidity

Question 3

What is tertiary prevention?

Answer 3

Improving health outcomes of people with diagnosed disease to prevent further morbidity.

Question 4

What kind of problems should be routinely screened for?

Answer 4

A problem that is considered serious due to death, disease, disability, discomfort, and dissatisfaction. Generally if you detect it early, treatment should be different to prevent it, than treating the disease once it’s been confirmed.
- Disability Adjusted life years

Question 5

What is key before implementing prevention?

Answer 5

• -Must be an effective and safe intervention that improves outcomes and delay progression
• • Cost effective
• • Serious-problem causing the DDDDDs and increased disability-life-years

Question 6

What is essential for screening?

Answer 6

• Screening the population when they are asymptomatic, and if positive there is treatment to reduce progression and mortality earlier.

Question 7

What are the characteristics of a screening program?

Answer 7

• High prevalence of the disease
• Eventual health problem is significant
• Cost effective screening

Question 8

What are essential features of a screening test?

Answer 8

1. Health condition must have a detectable pre-clinical phase
2. The screening test must perform well
3. Must be acceptable to patients to do

Question 9

What kind of accuracy should a screening test entail?

Answer 9

High Sensativity, Moderate specificity to avoid excessive work ups after a positive screen.

Question 10

What are examples of chemoprophylaxis?

Answer 10

• • ASA
• • Statins
• • Bisphosphonates
• • Folic Acid
• *Use of medication to prevent disease from occuring**

Question 11

What is length-time bias?

Answer 11

A screening test that picks up indolent disease, but miss fast growing cancers, so it appears people who are screened having a better prognosis since it only picks up the slow growing cancers.

Question 12

How to avoid lead-time bias and length-time bias in screening studies?

Answer 12

• • Randomization

- - Same time point for randomization to avoid lead-time

Question 13

What is the mnemonic to apply preventative care?

Answer 13

RISE
Risks of the patient
Immunizations of this patient
Screening for this patient
Education of this patient