Ch. 9 Screening

Question 1

What is the Primary objective of Screening?

Answer 1

Detection of a disease in its early stages in order to treat it and deter its progression

Question 2

What is the secondary objective of screening?

Answer 2

to reduce the cost of disease management by avoiding costly interventions required at later stages

Question 3

Define asymptomatic pathogenesis

Answer 3

latency; disease origin or development before symptoms first appear

Question 4

Screening is what type of prevention?

Answer 4

Secondary

Question 5

Advantages of Screening

Answer 5

• simple screenings can be preformed at home
• cost effective usually
• opportunity to educate those who may otherwise not get a change to get educated

Question 6

define individual screening

Answer 6

-one person is tested by a health professional who has designated the individual at high risk

Question 7

define group/mass screening

Answer 7

• a target population is selected on the basis of an increased incidence of a condition or recognized element of high risk within an identified group
• the target population may be invited to a central location at a designated time to be tested for the selected disorders

Question 8

define multiple test screening

Answer 8

the administration of two or more tests to detect more than one disease
-in some cases one sample can be used to evaluate the possibility of sever conditions, saving time and money. Ex: Blood tests

Question 9

What are the 5 A’s of Tobacco Cessations?

Answer 9

-recommended screening and counseling for successful tobacco intervention

Ask
Advise
Assess
Assist
Arrange

Question 10

What are some Disadvantages of screening?

Answer 10

• margin of error (any margin of error could result in serious consequences)
• maybe it is not cost effective
• invasive

Question 11

How is a Screening for a specific disease selected to be used?

Answer 11

-must also encompass emotional and financial impact of the disease detection on the population

1. Does its significance warrant its consideration as a community problem?
2. can the disease be detected by screening?
3. should screening for the disease be done?
   
   • what are the health benefits? can it be treated?
   • what are the tangible and intangible costs?

Question 12

define epidemiology

Answer 12

the study of the distribution and determinants of health related states in specified populations

Question 13

The significance of a disease refers to what?

Answer 13

the level of priority assigned to the disease as a public health concern. significance generally is determined by incidence and prevalence and by the quantity and quality of life affected by the disorder

Question 14

What may influence whether a disease should be screenable or not?

Answer 14

politics and special interest groups

Question 15

morbidity

Answer 15

• to a diseased state or disability from any cause

- broader terms… a range or degree of the illness that affects the person

Question 16

mortality

Answer 16

death

Question 17

incidence

Answer 17

rate of occurrence , the rate of a new population problem and estimates the risk of an individual developing the specific disease or condition during a specific period or over a lifetime

Question 18

prevalence

Answer 18

the proportion of a given population with the disease or condition at any one point in time. it provides the best estimate of whether a person is likely to become ill during a specific period of time.

Question 19

usually chronic disease are measured by their….

Answer 19

prevalence (generally existing)

Question 20

acute conditions are usually measured by their…

Answer 20

incidence (rate of occurrence)

Question 21

quality of life

Answer 21

• subjective

- how do they perceive the disability of the disease, do they even see one at all?

Question 22

QALY

Answer 22

• Quality Adjusted Life Year
• measurement of quality of health,
• utility value associated with a state of health by the years lived in that state of health

Question 23

DALY

Answer 23

• Disability Adjusted Life Year
• it measure the burden of a disease
• accounts for life lost and life quality diminished through disability

Question 24

Quantity of life

Answer 24

• severity of an incidence occurring

- cost associated with management

Question 25

Why is testing for PKU at birth done with every single baby?

Answer 25

- it is extremely cost effective - tested/detected within the first week of life there are things that can be done that make it treatable if detected now. if not the child will experience a lifetime of consequences and costs to manage

Question 26

A screenable disease should have what type of diagnostic criteria?

Answer 26

- well diagnostic criteria | - defined normal parameters that are wholly accepted

Question 27

Screening instruments should have what qualities?

Answer 27

- must be safe, cost effective, accurate - reliability - validity

Question 28

reliability

Answer 28

-an assessment of the reproducibility of the test's results when different individuals with the same level of skill perform the test during different periods and under different conditions

Question 29

interobserver reliability

Answer 29

if the same result emerges when two individuals perform the test

Question 30

intraobserver reliability

Answer 30

if the same individual is able to reproduce the results several times

Question 31

what does it suggest if interobserver reliability of a screening instrument is low?

Answer 31

additional training might be required to work toward a more consistent method of test delivery

Question 32

why would intraobserver reliability be necessary?

Answer 32

in substance abuse or mental health/depression screening

Question 33

validity

Answer 33

reflects the accuracy or truthfulness of the test or instrument itself

Question 34

false positive

Answer 34

individuals who do not have the disease but are referred for further tests because they test positive

Question 35

false negative

Answer 35

- worse! - those whose diseases where overlooked - they lose the opportunity to receive early treatment that could prevent irreversible damage

Question 36

Specificity

Answer 36

- measures the test's ability to recognize negative reactions or non-diseased individuals - excellent specificity = rare false positives - poor specificity = more common false positive

Question 37

Sensitivity

Answer 37

- refers to the proportion of people with a condition who correctly rest positive when screened - good sensitivity = less false negatives - poor sensitivity = lots of false negatives

Question 38

What kind of community resources affect whether a disease is screenable?

Answer 38

-funds, workers, follow-through, treatment sources, administrative personnel

Question 39

Lead Agency

Answer 39

overseas the development process of the community health program - Vary : from community service organization to local public health department - should partner with stakeholders (those who have legitimate interest in the topic)

Question 40

key community individuals

Answer 40

considered leaders within the community

Question 41

community assessment

Answer 41

- carried out by the members of the partnership - systematic method of data collection that provides a detailed account, first identifying need and subsequently determining the type, quantity and quality of resources