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Health Promotion 2 > Screening in oral healthcare > Flashcards

Screening in oral healthcare Flashcards

Understand prevention, define the principles of screening, understand the components of a screening programme

1
Q

What is prevention?

A

Actions that prevent disease occurrence. It aims to eradicate, eliminate or minimise the impact of disease and disability.

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2
Q

What can be prevented in dentistry?

A

Dental caries
Periodontal disease
Oral Cancer
Non-carious tooth surface loss.
Trauma

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3
Q

What are some prevention methods that we use?

A

Fissure sealants.
Topical fluorides
OHI
Smoking Cessation
Clinical exam
Promoting gum shields
Delivering health messages

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4
Q

What are the levels of prevention?

A

Primary
Secondary
Tertiary

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5
Q

What is primary prevention?

A

Preventing disease initiation.

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6
Q

What is secondary prevention?

A

Identifying disease early and impeding progression and recurrence.

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7
Q

What is tertiary prevention?

A

Reduce the onset or impact of complications.

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8
Q

What is screening?

A

The process of identifying apparently healthy people who may be at increased risk of disease.

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9
Q

Screening is based on a principle that is…

A

A detectable preclinical phase or latent phase.
Early detection and treatment of asymptomatic disease must offer some benefit in terms of reducing morbidity and mortality over later treatment.

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10
Q

Properties of a screening test are…

A

Cheap
Easy to use
Easy to interpret
Safe
Acceptable
Reliable
Valid

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11
Q

What gives the results of a screening test validity?

A

Sensitivity
Specificity
Positive predicative value
Negative predictive value

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12
Q

What is sensitivity?

A

The ability of the test to identify those with the disease.

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13
Q

What is specificity?

A

The ability of the test to identify those without the disease.

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14
Q

What does a high sensitivity mean?

A

That no cases will be missed.

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15
Q

What does a high specificity mean?

A

That there won’t be too many people put through unnecessary further tests and treatments.

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16
Q

What is a true positive?

A

It is when someone is predicted to have a disease and they do have it.

17
Q

What is a true negative?

A

when it is predicted that someone doesn’t have the disease and they don’t.

18
Q

What is a false negative?

A

When we predict someone doesn’t have a disease but they do.

19
Q

What is a false positive?

A

When we predict that someone does have a disease but they don’t.

20
Q

What is the positive predictive value?

A

If a person tests positive, what is the probability that they have the condition?

21
Q

What is the negative predictive value?

A

If a person tests negative, what is the probability that they don’t have the condition?

22
Q

What are the types of screening programmes?

A

Mass (population) screening
Selective screening
Opportunistic

23
Q

What are the characteristics of population screening?

A

Large scale screening of population groups.
Usually by invitation.

24
Q

What are the characteristics of selective screening?

A

Targeted by screening of high-risk groups.

25
Q

What are the characteristics of opportunistic screening?

A

Examining individuals when they attend for an unrelated purpose.

26
Q

What are the important components of a screening programme?

A

Test
People that take the test
Register to invite participants
Infrastructure to invite participants
People and infrastructure to read the test
People to record the test finding
People and infrastructure to to take and read further tests.
People and infrastructure to treat.
Support mechanisms
Quality assurance mechanisms.

27
Q

Advantages of a screening programme are…

A

Improved prognosis for some cases.
Less radical treatment which cures some early cases.
Resource savings
Reassurance for those with negative test results.

28
Q

What are the disadvantages of screening programmes…

A

Longer morbidity for cases where prognosis is unaltered.
Overtreatment of questionable abnormalities.
Resource costs
False reassurance for those with false-negative results.
Anxiety and sometimes morbidity for those with false positive results.
Hazard of screening test itself.

29
Q

What is the criteria for a screening programme?

A

The condition being screened for should be an important health problem.
The natural history of the condition should be well understoof.
There should be a detectable early stage.
Treatment at an early stage should be more of a benefit than at a later stage.
A suitable test should be devised for the early stage.
The test should be acceptable.
Intervals for repeating the test should be determined.
Health service provision should be made for the extra clinical workload from screening.
The risks should be less than the benefits.
The costs should be balanced against the benefits.

30
Q

Why does an oral cancer screening test not meet the screening criteria?

A

The epidemiology is not known.
Linked with tobacco and alcohol use.
Only 5% of white patches will become malignant, identification of which is unknown.
Dental practitioners are involved in reducing tobacco and alcohol use.
Existing public awareness campaigns.
Generally not inherited.
Rest of criteria not assessed.
Evidence is limited
Some evidence of poor quality.
Oral cavity exam, and suggested adjuncts unlikely to pose a problem.

31
Q

How would you calculate the Sensitivity?

A

The number of true positives divided by the total positives plus false negatives

32
Q

How would you calculate the specificity?

A

True negatives divided by true negatives plus false positives

33
Q

How would you calculate the positive predictive value?

A

True negatives divided by true positives plus false positives.

34
Q

How would you calculate the negative predictive value?

A

True negatives divided by true negatives plus false negatives.

35
Q

Why does oral cancer not meet the criteria for screening?

A

As it is unclear what lesions will become cancerous.
There is no reliable test.
Current research can’t be generalised to the UK.
Unclear definition of malignant lesions.

Health Promotion 2 (11 decks)

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