Screening Flashcards
what makes up health promotion
health education, screening and prevention
who took over overseeing preventive services and distributing them out to states from the CDC
US Preventative Services Task Force (USPSTF)
what is the purpose of screening
detect the disease in the early stages to stop disease from progressing and treat the disease also well as reduce cost of disease mgt
types of screenings: individual screening
-one person tested
-often chosen based on risk factors
-sometimes chosen based on universal screening
-ex) mammogram for a female w/ fam hx of BC
types of screenings: group or mass screening
-target population selected on basis of increased risk
-ex) vision screening in school children or testing for PKU in neonates
types of screenings: one test disease specific screening
-single test
-detects characteristic indicating high risk
-ex) A1c & DM or cholesterol levels & hypercholesterolemia
types of screenings: multiple test screening
-2 or more tests to detect one disease
- ex) tb screening -> blood test or skin test then if positive x rays and sputum cultures
screening criteria
-detection (are there well documented diagnostic criteria/resources or treatments to support screening)
-diagnostic criteria (disease should have early asym state + risk factors)
-screening measures (safe, cost effective, accurate)
advantages of screening
-cost effective
-can be individual or large pops
-some are mandated by law
-can be one test or multiple
-creates opportunity for health teaching
disadvantages of screenings
-possibility of errors (false positive or negatives)
-serious consequences to errors
what question should we ask ourselves when selection a disease to screen for
“just because we can, does it mean we should?”
-does it warrant a community problem
-can the disease be detected by screening
-health benefits
-tangible
when should a screen be done
-it has benefit w/ early detection
-if effective treatments are available
-there is follow up care
-it is safe
-low rate of false positives and over treatment
epidemiology
method used to find cause of disease (and outcomes) in populations
Morbidity
diseased state or disability from any cause (includes range or degree of illness)
mortality
deaths in a given population as a result of a specific disease/illness/event
significance
level of priority of disease as public health concern
significance
level of priority of disease as public health concern
incidence
rate of a new population problem & estimates risk of individual developing disease
prevalence
proportion of the population with disease at any one point in time
reliability
extent a measuring procedure yields consistent results on repeated administrations of the scale (exact same results everytime)
reliability: inter observer
same results when 2 person’s do tests
reliability: intra observer
same person able to reproduce results
validity
degree a measuring procedure accurately reflects or assesses or captures the specific concept that the researcher is attempting to measure (what you actually want to measure)
test sensitivity
the ability of a test to correctly identify those with the disease (true positive)
test specificity
the ability of a test to correctly identify those without the disease (true negative)
low sensitivity would equal
false positives
low specificity would equal
false negative
sensitivity and specificity are apart of what
validity
what screening issues need clarified
prevention, ameliorative, curative (what are costs to the pt)
cost of health screenings
-social & political forces becoming more cost conscious vs past practice
-do costs result in improved health? are benefits worth it?
3 approaches may be used to evaluate
-cost benefit ratio
-cost effectiveness
-cost efficiency analysis
*determine optimal use of resources to achieve desired health outcome
clinical preventive services
-saves years of life and help people live better during those years
-save money
-provide quality care
-reduce death, disability, and disease
USPSTF Grading: A
service recommended, high certainty that the net benefit is substantial
USPSTF Grading: B
recommends, there is a high certainty that the net benefits is moderate or there is moderate certainty that the new benefit is moderate to substantial
USPSTF Grading: C
recommends selectively offering or providing this service to individual pts based on professional judgement and pt preference
USPSTF Grading: D
recommends against the service
USPSTF Grading: I
insufficient evidence
