Screening tests Flashcards
1
Q
measures are designed to prevent the onset of a targetd condition; they are activities that help avoid a specific health care problem. Ex. smoking cessation can reduce the incidence of lung cancer
A
Primary preventitive
2
Q
- identify and treat asymptomatic persons who already have certain risk factors or in whom the condition is not already apparent
- Ex. a mammogram that detects early stage breast cancer can lead to more definitive and curative procedure
A
secondary preventitve
3
Q
- manages an exisiting disease, with the goal to restore a patient to the highest function, minimize the negative consequences of the disease and prevent disease related complications
- ex. eliminating offending allergens from an asthmatic patient’s environment and routinely screening for and managing renal, eye and foot problems in a diabetic pt
A
Tertiary prevention
3
Q
- evaluate asymptomatic healthy subjects in general population
- needs close monitoring or surveillance due to risks
- needs ongoing monitoring (well-childcare)
- sensitive- detect numerous patients with possible disease
- usually less expensive- ECG, fecal occult blood test
A
Screening Testing
4
Q
- abnormality detected, now must make the diagnosis
- rule in- or rule out
- predict clinical course or response to tx
- specific- accurately identify actual cases of disease
- usually invasice, more expensive
- ex. coronary angiography, colonoscopy
A
Diagnostic Testing
5
Q
- Searching for asymptomatic disease/ risk factors in a clinical setting
- individual/ pt based screening
A
Case Finding
6
Q
some criteria for effective screening
A
- the disease screened for has serious consequences
- the screening population has high prevalence of detectable preclinical disease
- the screening test cause little morbidity
- treatment is not too risky or toxic
- treatment exists
- screening test is affordible and available
7
Q
what are some costs of screening tests?
A
- false positives also increase the stress and anxiety
- screening tests can be inconvienient and worrisome to some patients
- false sense of security if false negative test result
8
Q
- refers to a tests ability to designate an individual with disease as positive
- this test means there are few false negatives
- important to choose test if there are serious consequences for missing the disease
A
Sensitivity
9
Q
- ability of a test to designate an individual does not have a disease, or is negative
- few false positive results
- tests that are low in this will screen positive and could cause pts to recieve unnecessary follow diagnostic procedures
A
Specificity
10
Q
- pt’s detected by screening should survive longer than those found after presentation
- period from diagnosis to death it increased- start tx earlier
- disease length doesn’t change
A
lead-time bias
11
Q
- higher risk people more eager to be screened, more positives, more prevalent
- more healthy, young pts screened can make the disease look less prevalent
A
selection bias
12
Q
- the same cancer can progress at varying lengths
- slower growing tumor more likely to be detected at screening and patients will live longer
- screening tends to find tumores with a better prognosis
A
Length bias
13
Q
what is the difference between incidence and prevalence
A
- prevalence is a measure of total number of cases of disease in population, rather than the rate of occurance of new cases (incidence).
- incidence conveys information about the risk of contracting the disease, prevalence indicates how widespread the disease is
14
Q
- USPSTF recommends the service, due to high net benefit. Well designed, well conducted studies to support
- blood pressure screening of adults aged 18 and older
- colorectal cancer screening starting age 50
- syphilis screening for persons at increased risk
A
Grade A
