Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MD2002 - ESA > Screening > Flashcards

Screening Flashcards

1
Q

What is screening?

A

Screening is the process of identifying healthy people may have an increase chance of a disease or a condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What happens during screening?

A
  • The screening provider then offers information, further tests and treatment. This is to reduce associated problems or complications
  • A population is selected to be screened. Then a few are sent to further tests, from which the individuals can receive further support and advice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why do we screen?

A

Screening can save lives or improve the quality of life through early identification of a condition

Screening can reduce the chance of developing a serious condition or its complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the condition of the Wilson and junger criteria?

A
  • Important public health problem
  • Natural history understood
    Recognise latent or early symptomatic phases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the Wilson and junger criteria for the test?

A
  • Simple, safe, precise and validated
  • Acceptable
  • Distribution of test results known and cut- off defined
  • Agreed on the policy on further diagnostic investigations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is th wilsom and junger criteria for the treatment?

A

Effective and available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the Wilson and junger criteria for the screening program?

A
  • Evidence from RCTs that screening is effective/accurate
  • Clinically, socially and ethically acceptable
  • Cost effective
  • Quality assured
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the WHO screening criteria 2008?

A
  • Response to a recognized need
  • Objectives defined and evaluation planned at outset
  • Defined target population
  • Scientific evidence of effectiveness
  • Programme should be comprehensive and integrated
  • Quality assured, with systematic mitigation of risks
  • Informed choice, confidentiality and respect for autonomy
  • Programme should promote equity and access to screening
  • The overall benefits of screening should outweigh the harm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What factors are considered for how well a screening test performs?

A
  • Sensitivity
  • Specificity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is sensitivity?

A

How well the test picks up having the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is sensitivity calculated?

A

Number of results where disease detected in people with the disease / Number of people with the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the benefits of sensitivity?

A
  • Picks upmost of the disease
  • Very few false negatives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is specificity?

A

How well the test detects not having the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is specificity calculated?

A

Number of normal results where disease is not detected in people without disease/ Number of people without disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the benefits of highly specific tests?

A
  • Correctly detects no disease
  • Very few false positives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What factors are considered for how accurate the results acheived?

A
  • Positive predictive value
  • Negative predictive value
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a positive predicitive value?

A

How reliable is the test result which shows a disease is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is a positive predictive value?

A

Number of people with the disease and a positive test result/ Number of people with a positive test result

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a negative predictive value?

A

How reliable is the test result showing disease is not present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do we know a screening programme is effective?

A
  • Was the evidence there that it would work?
  • Is it a systematic programme?
  • Are the right people invited, getting screened, receiving quality treatment and follow-up?
  • Is there good and effective clinical governance?
  • Are the inequalities inherent in screening programmes being systematically addressed?
  • Is the programme regularly reviewed for ways to enhance its effectiveness or check that it is still viable viability? (changes to positivity rates, acceptability, epidemiology, new treatments etc)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the current adult screening programs?

A

-Abdominal aortic aneurysm
Bowel cancer
Breast cancer
Cervical cancer
Diabetic retinopathy

23
Q

How is sensitivity calculated?

A

Number of results where disease detected in people with the disease / Number of people with the disease

24
Q

What do highly sensitive tests do?

A
  • Picks up most of the disease
  • Very few false negatives
25
What is specificity?
How well the test detects not having the disease
26
How is specificity calculated?
Number of normal results where disease is not detected in people without disease / Number of people without disease
27
What do highly specific tests do?
- Correctly detects no disease - Very few false positives
28
How can you tests how accurate the results achieved?
- Positive predictive value - Negative predictive value
29
What is positive predictive value?
How reliable is the test result which shows a disease is present
30
How is a positive predictive value calculated?
Number of people with the disease and a positive test result/ Number of people with a positive test result
31
What is the negative predictive value?
How reliable is the test result showing disease is not present
32
How is the negative predictive value calculated?
Number of people who tested negative and do not have the disease/ people who tested negative
33
How do we know a screening programme is effective?
- Was the evidence there that it would work? - Is it a systematic programme? - Are the right people invited, getting screened, receiving quality treatment and follow-up? - Is there good and effective clinical governance? - Are the inequalities inherent in screening programmes being systematically addressed? - Is the programme regularly reviewed for ways to enhance its effectiveness or check that it is still viable viability? (changes to positivity rates, acceptability, epidemiology, new treatments etc)
34
What are the current adult screening programs?
Abdominal aortic aneurysm Bowel cancer Breast cancer Cervical cancer Diabetic retinopathy
35
What are the current pregnancy screening programmes?
Fetal anomaly Infectious diseases Sickle cell and thalassemia
36
What are the current newborn and infant screening programmes?
Physical examination Blood spot Hearing
37
What are conditions for bowel cancer screening?
- Male and female - Ages 50- 74 - Frequency - every 2 years
38
What are the conditions fro breast cancer screening?
- Female - Ages 50-70 - Frequency - every 3 years
39
What are the conditions for cervical cancer screening?
- Female - Ages 25- 64 - Frequency every 5 years if HPV negative
40
What are the conditions for abdominal aortic aneurysm screening?
- Male - Ages 65 - One off scan
41
What are the conditions for diabetic retinopathy screening?
- Male and female with type 1 & 2 diabetes - less the 12 years old - Annually then 2 yearly if no retinopathy
42
What is the marmot review of the UK breast screening programme?
Estimated for 10 000 women invited to screening: - 681 cancers will be diagnosed, of which 129 (19%) will represent overdiagnosis. - 43 deaths from breast cancer will be prevented “UK breast screening programmes confer significant benefit and should continue.... Clear communication of [the associated] harms and benefits to women is of utmost importance
43
What are the benefits of taking part in screening?
- Reduced disease incidence - Reduced disease mortality - Earlier, less radical treatment - Cost - effective - Overall population benefit
44
What are the risks of taking part in screening?
- False reassurance - Over- investigation and treatment - Anxiety - Longer period of morbidity with unaltered prognosis - Harm from screening test - Opportunity costs - Increased health inequalities
45
What is the potential impact of screening on health inequalities?
- Ethical issue about equitable outcomes - Legal requirements of Equality Act - Increased cost of treatment, social care etc - Reduced effectiveness of the screening - Viability of the programme - Less inequality may be better for everyone
46
What is the equality act 2010?
1. In carrying out this activity are we sure there is no unlawful discrimination? 2. In carrying out this activity are we advancing equality of opportunity between those who have a protected characteristic and those who do not? 3. In carrying out this activity are we fostering good relations between persons who share a relevant protected characteristic and persons who do not share that characteristic?
47
What would cause inequalities in screening?
- Identifying and inviting screening cohort - Acceptability of test - Failure to make reasonable adjustments - Poor communication about the test results or the next steps in the programme - Prejudice leading to poor care
48
What are the challenges with optimising coverage with screening?
- Change of address - Migrants - Travellers - Prisoners - Students - Trafficked people
49
What are the challenges with optimising uptake with screening?
- Communication - Health literacy - Deprivation - Accessibility - Vulnerable groups - Minority ethnic group
50
Why does inequality in engagement matter?
- Equality of access is a legal duty - Positivity rates are affected by low coverage in high risk groups - Less lives saved, poorer outcomes, more treatment - Less faith in programme – downward spiral of engagement - Reduced effectiveness threatens programme viability as the balance of harm versus benefit changes
51
How can we improve engagement vulnerable groups?
- Social marketing - Everyone’s responsibility - Qualitative research - Known effective interventions - Letter from GP; patient navigation; community mentors; “people like me”; languages; text reminders; - Known barriers - Uncertainty of benefit; fear of the screened-for condition; lack of time; disgust/discomfort/embarrassment;

MD2002 - ESA (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions