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Questions and Answers
What is the primary purpose of screening tests?
What is the primary purpose of screening tests?
Screening tests require a physician to administer them.
Screening tests require a physician to administer them.
False (B)
What is one characteristic of diseases that makes them suitable for screening?
What is one characteristic of diseases that makes them suitable for screening?
Chronic diseases with a long natural history.
Screening can be considered a form of _______ prevention.
Screening can be considered a form of _______ prevention.
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Which of the following is NOT a criterion for instituting a screening program?
Which of the following is NOT a criterion for instituting a screening program?
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Match the following aspects of screening and diagnostic tests:
Match the following aspects of screening and diagnostic tests:
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A positive finding in a screening test indicates a definitive diagnosis.
A positive finding in a screening test indicates a definitive diagnosis.
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The process of finding people likely to have a disease is called _______.
The process of finding people likely to have a disease is called _______.
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What does sensitivity measure in a screening test?
What does sensitivity measure in a screening test?
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Specificity is the proportion of diseased people who test positive for the disease.
Specificity is the proportion of diseased people who test positive for the disease.
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What is the sensitivity of the screening test if 80 out of 100 diseased individuals test positive?
What is the sensitivity of the screening test if 80 out of 100 diseased individuals test positive?
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What is the primary purpose of screening tests?
What is the primary purpose of screening tests?
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The positive predictive value of a test indicates what proportion of patients who test positive ________ the disease.
The positive predictive value of a test indicates what proportion of patients who test positive ________ the disease.
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Screening tests are always a basis for treatment.
Screening tests are always a basis for treatment.
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Which of the following factors could increase the cost associated with screening tests?
Which of the following factors could increase the cost associated with screening tests?
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Match the following components with their definitions:
Match the following components with their definitions:
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What are the two main types of tests used in case-finding?
What are the two main types of tests used in case-finding?
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The specificity of the test is calculated as 800 out of 900 non-diseased individuals.
The specificity of the test is calculated as 800 out of 900 non-diseased individuals.
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Screening is used to detect disease predisposition so that individuals can be removed from exposure to specific __________.
Screening is used to detect disease predisposition so that individuals can be removed from exposure to specific __________.
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If a test has a specificity of 89%, what does this indicate about its performance?
If a test has a specificity of 89%, what does this indicate about its performance?
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Match the following terms with their definitions:
Match the following terms with their definitions:
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Which characteristic of screening tests indicates the ability to deliver consistent results on repeated trials?
Which characteristic of screening tests indicates the ability to deliver consistent results on repeated trials?
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In screening, it is essential for the diseases tested to be rare and not treatable.
In screening, it is essential for the diseases tested to be rare and not treatable.
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Name a common disease that is appropriate for screening.
Name a common disease that is appropriate for screening.
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What is the formula for calculating Positive Predictive Value (PV+)?
What is the formula for calculating Positive Predictive Value (PV+)?
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A high negative predictive value indicates a good cost benefit.
A high negative predictive value indicates a good cost benefit.
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What is the Negative Predictive Value when 800 out of 820 individuals tested negative?
What is the Negative Predictive Value when 800 out of 820 individuals tested negative?
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The reliability of a test is affected by biological variation and observer variation, known as _____ variation.
The reliability of a test is affected by biological variation and observer variation, known as _____ variation.
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Which of the following is NOT a characteristic of a good screening test?
Which of the following is NOT a characteristic of a good screening test?
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Match the terms with their meanings:
Match the terms with their meanings:
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What is one way to increase the reliability of a test?
What is one way to increase the reliability of a test?
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A high prevalence of disease can influence the _____ value of a screening test.
A high prevalence of disease can influence the _____ value of a screening test.
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Study Notes
General Principles of Screening
- Screening involves the presumptive identification of unrecognized diseases through tests applied to apparently healthy individuals.
- Aims to differentiate between those likely to have a disease and those who do not, but is not intended for diagnosis.
- Positive findings require further diagnostic evaluation.
Characteristics of Diseases Suitable for Screening
- Must be a significant public health issue.
- Has a known natural history and common prevalence.
- Effective treatment available if detected early.
Characteristics of Screening Tests
- Validity: Ability of tests to accurately measure the presence or absence of a disease, influencing treatment decisions.
- Reliability: Consistency of the test results when repeated under the same conditions.
- Acceptability: Tests should be simple, safe, and minimally invasive with no unpleasant implications.
Sensitivity and Specificity
- Sensitivity: Proportion of diseased individuals correctly identified by the screening test (e.g., 80% signifies good identification of those with the disease).
- Specificity: Proportion of non-diseased individuals correctly identified as negative by the test (e.g., 89% signifies good identification of those without the disease).
Predictive Value of Tests
- Positive Predictive Value (PV+): Measures the proportion of patients testing positive who actually have the disease; influenced by disease prevalence and test specificity.
- Negative Predictive Value (PV-): Measures the proportion of patients testing negative who do not have the disease.
Types of Screening
- Simple vs. Complex: Simple tests (e.g., rectal exams for prostate cancer) versus more comprehensive tests.
- Individual vs. Mass Screening: Targeted tests for individuals seeking care versus initiatives in broader populations (e.g., health camps).
- Routine vs. Ad-hoc: Regular screening programs vs. episodic based on specific exposures.
Appropriate Situations for Screening
- Social factors: Importance to individuals and communities, availability of follow-up care, favorable cost-benefit ratios, and high public acceptance.
Reliability of Screening Tests
- Ensuring reliability involves standardizing procedures, providing intensive training, conducting periodic checks, and using multiple independent observers.
The Iceberg Phenomenon
- Represents the concept that many cases of illness are hidden beneath the surface of what is diagnosed and managed by physicians, emphasizing the importance of proactive screening.
Screening vs. Diagnostic Tests
- Distinction lies in application scope; screening tests are conducted on broad populations while diagnostic tests are used on individuals with indications of disease.
- Screening tests are less expensive and generally less accurate, serving as preliminary evaluations, whereas diagnostic tests provide comprehensive assessments based on multiple symptoms and signs.
Aims of Screening Programs
- Detect predisposition to diseases to minimize exposure to risks.
- Facilitate early-stage detection of diseases for timely treatment intervention.
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Description
Explore the fundamental concepts of screening in healthcare, including the characteristics of diseases that are suitable for screening and the essential criteria for establishing screening programs. Delve into the iceberg phenomenon and understand what is visible and what lies beneath in patient health.
