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BIOEPI > SCREENING AND PUBLIC HEALTH SURVEILLANCE > Flashcards

SCREENING AND PUBLIC HEALTH SURVEILLANCE Flashcards

1
Q

Presumptive identification of an unrecognized disease or defect by the application of tests, examinations or other procedures that can be applied rapidly
Mainly used to identify ASYMPTOMATIC INDIVIDUALS at an earlier stage in the natural history of diseases

A

Screening

Assumption: Earlier diagnosis leads to earlier treatment that will improve diseases prognosis

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2
Q

Screening test vs. Diagnostic test:
Asymptomatic individuals
Less accurate
Less expensive
Not a basis for treatment: not meant to be diagnostic
Sort out apparently well individuals who probably have a disease from those who probably not

A

Screening

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3
Q 
Screening test vs. Diagnostic test:
Symptomatic individuals 
More accurate
More expensive
Basis for treatment
A

Diagnostic Test

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4
Q

Characteristics of a Disease Appropriate for Screening:

Given the high cost and possible adverse consequences of screening it is only justifiable to screen for major diseases

A

Disease is serious with severe consequences

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5
Q

Characteristics of a Disease Appropriate for Screening:
Screening is carried out in the premise that the natural history of the disease can be altered by earlier treatment
Ex: breast cancer is better with screening vs pancreatic cancer

A

Treatment is more effective at an earlier stage

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6
Q

Characteristics of a Disease Appropriate for Screening:
Screening test is designed to identify initial biologic abnormalities so that the affected individual comes to medical attention earlier

A

Disease has a clinical detectable preclinical stage

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7
Q

Characteristics of a Disease Appropriate for Screening:

It is not efficient or cost effective to screen for rare or acute diseases

A

The preclinical phase is fairly LONG and prevalent in the target population

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8
Q

ODD MAN OUT:
Characteristics of a Screening Test

  1. Economical or cost effective: expense of the test must be considered relative to the benefit of the early diseases detection
  2. Convenient: simple and can be done rapidly
    Relatively free of risk and discomfort
  3. Acceptable to a large number of individuals: participation is voluntary
  4. Highly valid and reliable: ability of test gives the consistent results
  5. Large amount of human resource required
A
  1. Large amount of human resource required
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9
Q

Evaluation of Screening Programs:

Screening programs should be conducted efficiently, with minimal inconvenience and discomfort and reasonable cost

A

Feasibility

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10
Q

Evaluation of Screening Programs:

Screening programs should achieve its goal of reducing morbidity and mortality

A

Effectiveness

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11
Q

TRUE OR FALSE:

Effectiveness of a Screening Program:
Customary way: comparison of the survival experience of a screened population with that of an unscreened population

A

TRUE

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12
Q

Potential Systematic Errors:

occurs when individuals who volunteer for a study differ in relevant clinical characteristics from those who do not

A

Volunteer bias

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13
Q

Potential Systematic Errors:

Phenomenon where early diagnosis of a disease falsely makes it look like people are surviving longer

A

Lead-time bias
Lead time: interval between the time of disease detection
Through screening and the time of disease recognition in the absence of screening

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14
Q

Potential Systematic Errors:
Phenomenon whereby slower-growing, less aggressive tumors have a longer preclinical screen-detectable period
Are therefore more likely to be screen-detected than faster-growing, more aggressive cancers

A

Length time bias

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15
Q

Types of Screening:
____: general population; Newborn screening
____: high-risk groups; Mammography and pap smear
____: case-finding; Aimed at patients who consult a health practitioner for some other purpose
____: several screening tools to detect several conditions at the same time; Detecting STDs

A

Mass screening
Targeted screening
Opportunistic screening
Multiphasic screening

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16
Q

Multiple Screening tests:
those who are positive on the first test will be subjected to the second test
Aka serial testing
Test increases overall specificity

A

Sequential

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17
Q

Multiple Screening tests:
participants are subjected to two or more tests at the same time
Aka parallel testing
Test that increases overall sensitivity

A

Simultaneous

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18
Q

French: “sur” (over) + “veiller” (to watch)
A systematic collection, collation, and analysis of data, and the prompt dissemination of the resulting information to those who need to know so that action can result
Continuing scrutiny of all aspects of the occurrence and the spread of a disease that are pertinent for effective control

A

Public Health Surveillance

Provides and interprets data to facilitate the prevention and control of disease
Most important purpose of public health surveillance
Should always have clear objectives
Includes clear description of how data will be used to prevent or control the disease

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19
Q

TRUE OR FALSE:
Information Loop of Public Health Surveillance:

Starts from the collection in the public and then collation, analysis and interpretation in the health agencies and lastly the dissemination and utilization of the public

A

TRUE

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20
Q

ODD MAN OUT:
Objective of Public Health Surveillance

  1. Detect epidemics
  2. Reveal hidden public health data
  3. Monitor intervention program
  4. Monitor impact of policy change
  5. Monitor health system
A
  1. Reveal hidden public health data
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21
Q

ODD MAN OUT:
Actions in Public Health Surveillance

  1. Office expansion
  2. Epidemic response
  3. Program monitoring
  4. Health policy
  5. Resource allocation
A
  1. Office expansion
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22
Q

ODD MAN OUT:
Data in Public Health Surveillance

  1. Early warning information
  2. Program indicators
  3. Top-secret data
  4. Health indicators
  5. Administrative data
A
  1. Top-secret data
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23
Q

ODD MAN OUT:
System in Public Health Surveillance

  1. One-way information exchange
  2. Active surveillance
  3. Health information
  4. Health information and management
A
  1. One-way information exchange
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24
Q

Unit of Surveillance:

detection of epidemics, newly emerging health problems or changes in health practices

A

Immediate detection

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25
Q

Unit of Surveillance:

estimating the magnitude of a health problem (cost, assessing control activities, and setting research priority)

A

Periodic Dissemination

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26
Q

Unit of Surveillance:
describing the natural history of disease, facilitating epidemiologic in laboratory research, and documenting distribution and spread of disease and inquiry

A

Stored information

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27
Q

ODD MAN OUT:
Characteristics of a well-conducted Public Health Surveillance System:

Acceptability 
Flexibility
Cheapness
Validity
Quality
Representativeness 
Stability
Simplicity
Timeliness
A

Cheapness

28
Q

Essential Activities of Public Health Surveillance:
Defining the Health Problem: allows to decide whether the person has the disease or not
Case definition for surveillance
Operational definition of the health problem for it to be accurately and reliably recognized and counted
Might differ from the following: Clinical criteria for diagnosing the disease
Case definition of the disease used in outbreak investigations
Ex: Follows a very strict criteria for every type of case

A

Identify, define, and measure the health problem of interest

29
Q

A person with sudden onset of fever (> 38.50C rectal or 38C axillary) and one of the following signs:

  • neck stiffness
  • altered consciousness
  • other meningeal sign
A

Suspected Case

30
Q

A suspected case with CSF examination showing at least one of the following:

  • turbid appearance
  • leukocytosis
  • elevated protein
  • decreased glucose
A

Probable Case

31
Q

A suspected case that is laboratory-confirmed

A

Confirmed Case

32
Q

uses less specific criteria
Used when identifying and counting the occurrence of a disease consist of a constellation of signs and symptoms, chief complaints or presumptive diagnosis, rather than the specific clinical or laboratory diagnostic criteria

A

Syndromic Surveillance
Goal: earlier detection of an unusual increase in illnesses than the traditional surveillance might to facilitate early intervention
Data sources: emergency departments, relies on computer methods to identify deviation from the baseline

33
Q

ODD MAN OUT:
Defining the Scope of Surveillance

Geographic area
Population covered
Resources
Time period

A

Resources

34
Q

Essential Activities of Public Health Surveillance:
From multiple sources using selected methods; data from this sources might originally be collected for purposes that are different from the objectives of the surveillance

A

Collect and compile data about the problem
Understanding the natural history of the disease is critical in surveillance
Determines how best to conduct surveillance for the disease

35
Q

ODD MAN OUT
Typical Sources of data used in surveillance and collection of data :

  1. Individual persons
  2. Health care providers, facilities and records
  3. Doctor’s clinic, hospital (OPD,ER), Laboratories
  4. Environmental conditions : Air, water
  5. Administrative actions
  6. Passport
  7. Financial transactions: Sales of goods and services, tax
  8. Legal actions
  9. Laws and regulations
A
  1. Passport
36
Q

Methods of Collecting Health-Related Data:
hazard surveillance
supplement for surveillance and not specific to surveillance

A

Survey

37
Q

Methods of Collecting Health-Related Data:

hazard surveillance

A

Environmental Monitoring

38
Q

ODD MAN OUT:
Methods of Collecting Health-Related Data

Notification
Registries
Re-analysis of secondary data
Data Editing

A

Data Editing

39
Q

Passive Vs. Active Surveillance:

Health care providers send reports to health departments on the basis of a known set of rules and regulations

A

Passive (Provider initiated surveillance)

40
Q

Passive Vs. Active Surveillance:
Health departments contact health care providers to solicit reports
Limited to specific diseases over a limited period of time

A

Active (Health Agency initiated surveillance)

41
Q

Relies on a pre-arranged sample of health care providers who agree to report all cases of certain conditions
Sample might not be a representative of the entire population
Reporting is probably consistent over time because the sample is stable and participants are committed to providing high quality data

A

Sentinel Surveillance

42
Q

Essential Activities of Public Health Surveillance:

it is when data analysis and interpretation is done

A

Analyze and interpret the data

43
Q

Basic Considerations of Analyzing and Interpreting data:

Data from individual cases are analyzed differently form data aggregated

A

Different data imply different types of analysis

44
Q

Basic Considerations of Analyzing and Interpreting data:
Computation of rates of disease or other health-related condition
Description of the occurrence of disease in terms of person, place and time
To determine whether the incidence/prevalence has changed

A

Descriptive methods are usually appropriate

45
Q

Basic Considerations of Analyzing and Interpreting data:
Health problem, temporal and geographic patterns of occurrence
Analysis by Time

A

Selection of data for comparison depends on:

46
Q

A if only the first statement is correct
B if only the second statement is correct
C if both of the statements are correct
D if neither of the statements is correct
Analysis by Time
1. Purposes is to characterize trends and detect changes in disease incidence
2. Data organization does not include tables, graphs or combination

A

A

47
Q

A if only the first statement is correct
B if only the second statement is correct
C if both of the statements are correct
D if neither of the statements is correct
Methods of Analysis by Time

  1. Comparison of the number of case reports received for the current week with the number received in the preceding weeks.
  2. Comparison of the number of cases during the current period to the number reported during the same period for the last 2-10 years
A

C

48
Q

A if only the first statement is correct
B if only the second statement is correct
C if both of the statements are correct
D if neither of the statements is correct
Methods of Analysis by Time

  1. Description of the case reports
  2. Analysis of long-term time trends
A

B

49
Q

A if only the first statement is correct
B if only the second statement is correct
C if both of the statements are correct
D if neither of the statements is correct
Analysis by Place

  1. Rates are often calculated by adjusting for differences in population size
  2. Rates are usually hidden and not displayed in a table or a map
A

A

50
Q

A if only the first statement is correct
B if only the second statement is correct
C if both of the statements are correct
D if neither of the statements is correct
Analysis by Place and Time

  1. Disease occurrence is often analyzed by time and place simultaneously
  2. Analysis can be organized and presented in: (Tables
    Series of maps highlighting different periods or populations)
A

C

51
Q

thematic map used to represent the statistical data through various shading patterns or symbols on predetermined geographic areas
Other sophisticated applications following the advent of geographic information systems

A

Choropleth maps or spot and shaded maps

52
Q

A if only the first statement is correct
B if only the second statement is correct
C if both of the statements are correct
D if neither of the statements is correct
Analysis by Person

  1. Most common person characteristics are age, sex, race and ethnicity
  2. Person variables useful for analysis do not depend on the health problems
A

A

53
Q

TRUE OR FALSE:

Standard categorization of age must not be mutually exclusive and all inclusive

A

FALSE
Mutually exclusive: end of one category cannot overlap with the beginning of the next category
All inclusive: categories should include all possibilities including the extremes of age and unknowns

54
Q

Interpreting result of analysis:
Increase in the incidence
Variation in pattern of disease in a specific population at a particular time and place from what is expected

A

Scenario

55
Q

Interpreting result of analysis:
Further investigation
Prevention or control measures

A

Response

56
Q

ODD MAN OUT:
Common causes of artifactual or artificial changes:

Changes in case definition
Laboratory error
Duplicate reporting
Tampering of data
Increase in population size
Ne lab test / diagnostic procedure 
Batch reporting
A

Tampering of data

57
Q

Essential Activities of Public Health Surveillance:
Disseminating Data and Interpretations
Timely, regular dissemination of basic data and their interpretation is a critical component of surveillance

A

Provide these data and their interpretation to those responsible for controlling health problem

Providers of reports
Persons, agencies or institutions who use surveillance data for planning or managing control programs, administrative purposes or other health related decision making

58
Q

Essential Activities of Public Health Surveillance:
Purpose of Evaluating Surveillance Systems
Identifies elements of surveillance that should be enhanced to improve its attributes
Improves the quality of data and interpretations provided by surveillance
Assesses how surveillance findings affect control efforts

A

Monitor periodically, evaluate the usefulness and quality surveillance to improve it for future use

59
Q

Framework of Public health surveillance and action:
Aggregated reports from PIDSR are incorporated into the annual morbidity report of the Field Health Services Information System

A

Philippine Integrated Disease Surveillance and Response (PIDSR)

60
Q

Four Major Disease Surveillance Systems prior to PIDSR:
Hospital-based surveillance system that yields information on admitted cases of diseases with outbreak potential in sentinel hospitals and which can serve as an early warning system for epidemics in the community

A

National Endemic Sentinel Surveillance System (NESS)

61
Q

Four Major Disease Surveillance Systems prior to PIDSR:
Monitoring of priority vaccine-preventable diseases targeted for eradication and elimination, namely: poliomyelitis, measles and neonatal tetanus

A

VPD Surveillance: vaccine-preventable diseases

62
Q

Four Major Disease Surveillance Systems prior to PIDSR:

Keeps track of the number of HIV-AIDS cases through a voluntary testing program.

A

HIV-AIDS Registry

63
Q

Four Major Disease Surveillance Systems prior to PIDSR:

Generates information on 17 diseases and 7 syndromes

A

Notifiable Disease Reporting System (NDRS)

64
Q

Approaches of PIDSR:

reports of cases and events come from diseases reporting units (DRUs)
Community
Barangay health stations
Rural health units
City health offices
Government/private hospitals or clinics 
Government/private laboratories
Ports and airports
A

Facility and community based approaches

65
Q

Approaches of PIDSR:

set of data collected for every case of notifiable disease or syndrome seen or detected on the DRUs

A

Case-based data collection

BIOEPI (13 decks)

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