Screening Flashcards

1
Q

What is an indication for screening

A

When early diagnosis of a disease allows early intervention to improve prognosis

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2
Q

What does a screening test do

A

Identifies those most likely to have the condition and those least likely to have it

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3
Q

What can low risk individuals be split into

A

True negatives and false negatives

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4
Q

What can high risk individuals be split into

A

True positives and false positives

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5
Q

What is represented by letters a, b, c, d

A

a - true positive
b - false positive
c - False negative
d - True negative

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6
Q

What is sensitivity and how do you calculate it

A

ability to pick up true positives

a/a+c

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7
Q

What is specificity and how do you calculate it

A

Ability to exclude true negatives

d/b+d

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8
Q

What is predictive value and how do you calculate it

A

Proportion of test results that are correct

a/a+b OR d/c+d

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9
Q

What are the benefits of screening

A

people prefer not to get ill
Widespread belief that early detection is better
Do no harm

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10
Q

What are the challenges of screening

A

generally low screening low prevalence populations
high specificity required
Leads to lower sensitivity

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11
Q

How is hypertension screened for

A

Blood pressure compared to those taken in a doctor’s surgery

Gold standard = measurements over time

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12
Q

Why is choosing diagnostic cut off important

A

Moving in either direction either causes too many false positives or false negatives

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13
Q

What programmes are currently offered in the UK

A

Antenatal screening
Newborn
Adult cancer
Other

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14
Q

What is screened for in antenatal screening

A

Fetal anomalies
Infections e.g. syphillis, HIB, Hep B
Sickle cell and thalassaemia
Physical abnormalities

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15
Q

What is the screening programme for newborns

A

Physical exam for eyes, heart, hips, testes
Hearing
Blood spots

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16
Q

What cancers are screened for

A

Breast (F 50-70)
Cervical (F 25-64)
Bowel (60-74)

17
Q

What other conditions are screened for

A

Abdominal aortic aneurysm (M 65)

Diabetic retinopathy

18
Q

What are some additional screening programmes

A

NHS vascular checks
Prostate cancer
Chlamydia

19
Q

What is the WHO screening criteria for the disease

A

Important health problem well
Well recognised pre-clinical stage
Natural history understood
Long latent period

20
Q

What is the WHO screening criteria for the test

A

Valid (sensitive and specific)
Simple and cheap
Safe and acceptable
Reliable

21
Q

What is the WHO screening criteria for the diagnosis and treatment

A

Facilities are adequate
Effective, acceptable and safe treatment available
Cost effective and sustainable

22
Q

How often are cervical cancer screens

A

Every 3 years from 34 and every 5 years >50

23
Q

How effective is cervical cancer screens

A

67% reduction in stage 1A and 70% deaths are prevented