Screening in Oral Health Care Flashcards

Question

What groups are targetted in selective screening programmes?

Answer 1

high risk groups

Answer 2

* test * people to take the test * register to invite participants * infrastructure to invite and re-invite participants * people and infrastructure to read the test * people to record test finding * people and infrastructure to take and read further tests * people and infrastructure to treat * support mechanisms * quality assurance mechanisms

Answer 3

* improved prognosis for some cases * less radical treatment which cures some early cases * resource savings * reassurance for those with negative test result

Answer 4

* longer morbidity for cases whose prognosis is unaltered * overtreatment of questionable abnormalities * resource costs * false assurance for those with false negative results * anxiety and sometimes morbidity for those with false positive results * hazard of screening test itself

Answer 5

* condition being screened should be an important health problem * natural history of condition should be well understood * should be a detectable early stage * treatment at an early stage should be more beneficial than at a late stage * suitable test devised for early stage * test should be acceptable * intervals for repetition should be determined * adequate health service provision should be made for extra clinical work load resulting from screening * risks, physical and psychological, should be less than benefits * costs should be balanced against the benefits

Answer 6

PHE 2015 | public health england

Answer 7

False No, criterion not met

Answer 8

Red or white patches

Answer 9

1. condition should be an important health problem judged by severity and frequency. Epidemiology, indicence, prevalence and natural history should be understood including development from latent to declared disease. There should be robust evidence about association betweeing risk of disease marker and serious or treatable disease 2. all cost effective primary prevention interventions should have been implemented as far as practicable 3. if the carriers of a mutation are identified as a result of screening the natural history of people with this status should be understood including psychological implications 4. there should be simple, safe, precise and validated screening test 5. the distribution of test values in the target population should be known and a suitable cut off level defined and agreed 6. the test, from sample collection to delivery of results, should be acceptable to target population 7. there should be an effective intervention for patients identified through screening with evidence that intervention at a pre-symptomatic phase leads to better outcomes for the screened individial compared to usual care 8. there should be agreed evidence based policies covering which individuals should be offered interventions and appropriate interventions to be offered 9. there should be evidence from high quality randomised controlled trials that the screening programme is effecive in reducing morbidity and mortality 10. there should be evidence that the complete screening programme (test, diagostic procedures, treatment/intervention) is clincally, socially and ethically acceptable to health professionals and the public 11. benefit gained by individuals from screening programme should outweigh harms for example overdiagnosis or overtreatment, false positives, false reassurance, uncertain findings and complications 12. the opportunity cost of screening programme (testing, diagnosis, treatment, admin, training and quality assurance) should be economically balanced in relation to expenditure on medical care as a whole- should be value for money 13. clinical management of the condition and patient outcomes should be optimised in all health care providers prior to participation in a screening programme 14. all other options for managing the condition should habe been considered (e.g. improving treatment) to ensure that no more cost effective intervention could be introduced or current interventions increased within resources available 15. there should be a plan for managing and monitoring screening programmes and an agreed set of quality assurance standards 16. adequate staffing and facilities for testing, diagnosis, treatment and programme management should be available prior to commencement of screening programme 17. evidence based information explaining purpose and potential consequences of screening, investigation and preventive intervention or treatment, should be made available to potential participanys to assist them in making an informed choice 18. public pressure for widening eligibility criteria for reducing the screening interval, and for increasing the sensitivity of the testing process should be anticipated. Decisions about these parameters should be scientifically justifiable to the public

Answer 10

* DPs involved in programes to reduce tobacco and alcohol use * existing public and professional awareness campaigns

Answer 11

* vital rinsing or staining with toluene blue, tolonium chloride * light based detection (vizilife, vizilife plus) * VELscope, orascoptic DK * mouth self examination * blood and saliva analysis

Answer 12

0.74 sensitivity 0.99 specificity

Answer 13

reduces need for radiotherapy and associated morbidity

Answer 14

False they do suggest cost effectiveness

Answer 15

* which lesions become cancerous * a reliable test suitable for UK primary dental care