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Flashcards in Screening Deck (30):
1

List the 5 major screening programmes used on adults.

Abdominal aortic aneurysm
Bowel cancer
Breast cancer
Cervical cancer
Diabetic retinopathy

2

List the 3 screening programmes used during pregnancy.

Fetal anomaly
Infectious diseases
Sickle cell thalassaemia

3

List the 3 screening programmes used on newborns & infants.

Physical examination
Blood spot
Hearing

4

How often is bowel cancer screening carried out and in what age group?

Every 2 years
50-74

5

How often is breast cancer screening carried out and in what age group?

Every 3 years
50-70

6

How often is cervical cancer screening carried out and in what age group?

Every 3 years
20-60 (from June 2016, 25-64)

7

How often is AAA screening carried out and in what age group?

It is a one-off scan
65

8

How often is diabetic retinopathy screening carried out and in what age group?

Annually
Over and including the age of 12

9

What is screening?

A process of identifying apparently healthy people who may be at increased risk of a disease or condition

10

What is the main difference between screening and diagnostic testing?

A non-negative result on screening does not necessarily equal disease-free

11

What are the three major differences between healthcare and screening

Patient/NHS initiated
Symptomatic/Asymptomatic
Hope of benefit/Implied benefit

12

How would you assess the merits of a screening test?

How does it perform?
- Sensitivity?
- Specificity?
When applied to population, how accurate are results achieved?
- Positive/Negative predictive value

13

What is the SENSITIVITY a measure of?

HOW WELL THE TEST PICKS UP HAVING THE DISEASE

14

How would you calculate the sensitivity?

Number of results where disease detected in people with the disease
____________________
Number of people with the disease

x100%

15

What is the SPECIFICITY a measure of?

HOW WELL THE TEST DETECTS NOT HAVING THE DISEASE

16

How would you calculate the specificity?

Number of normal results where disease is not detected in people without the disease
___________________
Number of people without the disease

x100%

17

What can you say about a highly sensitive test result?

Picks up most of the disease
Very few false negatives

18

What can you say about a highly specific test result?

Correctly detects no disease
Very few false positives

19

What is a positive predictive value?

How reliable the test result is in showing that the disease is present

20

How would you calculate the positive predictive value?

Number of people with the disease and a positive test result (i.e. showing disease presence)
___________________
Number of people with a positive test result (i.e. showing disease presence)

x100%

21

What is a negative predictive value?

How reliable the test result is in showing that the disease is not present

22

How would you calculate the negative predictive value?

Number of people who do not have the disease and a negative test result (i.e. showing no disease presence)
___________________
Number of people with a negative test result (i.e. showing no disease presence)

x100%

23

What can the positive and negative predictive values be affected by?

Prevalence

24

List some of the advantages associated with screening.

Reduced disease incidence
Reduced disease mortality
Earlier, less radical treatment
Overall population benefit
Cost-effective

25

List some of the disadvantages associated with screening.

False reassurance
Over-investigation and treatment
Anxiety
Longer periods of morbidity with unaltered prognosis
Harm from screening test
Opportunity costs

26

What is the 'gold standard' in measuring the effectiveness of screening?

Randomised controlled trial

27

Is screening mandatory and do you as a physician need consent to carry it out?

No, it is not mandatory and yes, informed consent must be given prior to screening being carried out

28

How would you calculate screening coverage in a population?

Screened population / Eligible population

x100%

29

How would you calculate screening uptake of a population?

Screened population / Invited population

x100%

30

There are challenges in getting maximum coverage and uptake of screening. How does the NHS strive to overcome these challenges?

Promotion of screening programme
Material in variety of languages
'The wee C'
'The Smear Amnesty'