Screening and Oral Health Flashcards

1
Q

What is the purpose of screening for a disease?

A
  1. detect disease at a pr-symptomatic stage to interrupt the natrual history of the disease
  2. detect individuals vulnerable to disease and reduce their risk
  3. enable informed repoductive choices
  4. protect public health
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2
Q

What is screening?

A

process of identifying unrecognised conditions by rapidly applied tests on a large scale

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3
Q

T/F screening is diagnostic

A

False

it needs further follow up

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4
Q

What are the three types of screening available?

A

selective screening
mass screening
oppurtunistic screening

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5
Q

When is selective screening used?

A

single diseases e.g chest x rays in coal miners

Multiphasic: antenatal exams

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6
Q

When is mass screening used?

A

single disease=cervical screening, breast cancer

multiphasic: routine check ups in people aged 75

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7
Q

When is oppurtunistic screening used?

A

this is used in people when they visit the healthcare setting and because they’ve come in, you take this opportunity to screen them then

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8
Q

What are the advanatges of selctive screening?

A

it identifies those that are at high risk of the disease and screens early for the disease.
it then allows for behaviour modifications

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9
Q

What are the benefits of screening in general?

A
preventative
reduces morbidity and mortality
reduces cost
less radical treatment
reassurance for those deemed healthy
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10
Q

What are some of the criteria for a screening programme to be implemented? Which committee outlines these?

A

UK national Screening Committee Criteria

Condition needs to be an important health problem
Natrual history of the disease needs to be well understood
Suitable test available
test should be acceptable
promgramme needs to be effective at reducing morbidity and mortality
benefits should outweigh the harm
needs to be an accepted treatment
Agree policy on who to treat

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11
Q

What diseases are suitable for screening?

A

those where ealry therapy is more succesful than late therapy
Condition has slow but progressive histpry
effects of disease are major
prevalance is high

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12
Q

what are the four stages to screening?

A

identify those at risk groups
application of the screening test
application of apprporate diagnostic tests
treat those with positive results

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13
Q

WHat two things should screening tests have?

A

high level of sensitivity and specificity

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14
Q

What does sensitivity refer to?

A

probability that the test will be positive if the disease is truly present

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15
Q

What does specificity refer to?

A

probability that the test will be negative if the disease is truly absent

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16
Q

False positives refers to…

A

sensitvitiy

17
Q

false negatives refers to…

A

Specificity

18
Q

What values can be obtained from screening tests?

A

positive and negative predictive values

19
Q

What do positive predictive values relate to?

A

probability of truly having a disease when a screening test is positive

20
Q

What do negative predictive values relate to?

A

probability of being disease free when the screeing test is negative

21
Q

What three things can be screened to check oral health?

A

Caries
Periodontal disease
Oral cancer

22
Q

How could we screen for caries?

A

School dental screening

23
Q

What reasons are there for not screening for periodontal disease?

A

Not a major health effect

Difficult to measure

24
Q

What would be a reason for not screening for oral cancer?

A

Low prevalence

Not cost effective

25
Q

What are the risk factors for caries?

A

SES

Physical characteristics eg pits and fissures

26
Q

How did the school dental screening programme work?

A

Visited 3 times during school career by the community dental service (CDS)
Letter was then sent home to patents whether positive or negative for caries
If pos then invited to contact the CDS Or make appt with the GDP

27
Q

Why was school screening discontinued?

A

Based on RCT Nov 2006 school screening not:

  1. Effective at reducing caries
  2. Effective in increasing dental attendance
28
Q

In which countries in UK is school dental screening still performed,ed?

A

Scotland

England and Wales in High risk and special schools

29
Q

How should screening for oral cancer be carried out?

A

Opportunistic eg. At appointments