screening Flashcards

1
Q

is it normal to be screened in the uk

A

no it is rare

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2
Q

what is screening

A

a process which sorts out apparently well people who probably have a disease (or precursors or susceptibility to a disease) from those who probably do not

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3
Q

is screening intended to be diagnostic

A

no

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4
Q

types of prevention

A

primary prevention
secondary prevention
tertiary prevention

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5
Q

main purpose of screening

A

secondary prevention
detect early disease to alter the course of the disease

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6
Q

what does screening want to achieve

A
  • reduce the risk of developing disease
  • provide treatment
  • provide information
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7
Q

define sensitivity

A

the proportion of people with the disease who are correctly identified by the screening test

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8
Q

define specificity

A

the proportion of people without the disease who are correctly excluded by the screening test

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9
Q

define positive predictive value

A

the proportion of people with a positive test result who actually have the disease

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10
Q

define negative predictive value

A

the proportion of people with a negative test result who do not have the disease

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11
Q

what are predictive values dependent on

A

underlying prevalence
whereas sensitivity and specificity are not

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12
Q

what is screening criteria based on

A

wilson and jugner criteria

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13
Q

what is the wilson and jugner criteria for the condition

A
  1. the condition should be an important health problem
  2. the natural history of the condition should be well understood
  3. there should be a detectable early stage
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14
Q

what is the wilson and jugner criteria for the treatment

A
  1. there should be an accepted treatment for patients with recognised disease
  2. facilities for diagnosis and treatment should be available
  3. adequate health service provision should be made for the extra clinical workloud resulting from screening
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15
Q

what is the wilson and jugner criteria for the test

A
  1. a suitable test should be devised for the early stage
  2. the test should be acceptable
  3. intervals for repeating the test should be determined (not a one off)
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16
Q

what is the wilson and jjugner criteria for the risks and benefits

A
  1. there should be an agreed policy on whom to treat
  2. the costs should be balanced against the benefits
  3. the risks, both physical and psychological, should be less than the benefits
17
Q

3 types of biases

A

selection bias
lead-time bias
length-time bias

18
Q

what is selection bias

A

people who choose to participate in screening programmes may be different from those who do not

19
Q

describe breast cancer screening

A

eligible group - women
test - 2 view mammography
further tests - mammography, biopsy, ultrasound, cytology
treatment - surgery, radiotherapy, chemotherapy
avoiding - overall deaths in screened women

20
Q

5 types of screening

A
  1. population based screening programmes
  2. opportunistic screening
  3. screening for communicable diseases
  4. pre employment and occupational medicals
  5. commercially provided screening