HP_200_Screening

HP_200_Screening - Michael Roybal, M. D., M.P.H...

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Michael Roybal, M. D., M.P.H Screening: Issues and Controversies in Implementing Programs in Disease Detection 1 9/6/06 Screening: Understanding Screening: Understanding Programs in Disease Programs in Disease Detection Detection Michael Roybal, M. D., M.P.H. HP 200 September 7, 2006 Fall 2006 9/6/06 Introduction Introduction Define Screening Introduction to Biostatistic Principles Underlying Screening Principles of Early Disease Detection Contemporary Examples Ethical and Social Issues 9/6/06 Prevention Measures Prevention Measures Primary Secondary Tertiary 9/6/06 Primary Prevention Primary Prevention Those measures provided to individuals to prevent the onset of a targeted condition. Examples: Immunization, Sanitation, Clean water Supply
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Michael Roybal, M. D., M.P.H Screening: Issues and Controversies in Implementing Programs in Disease Detection 2 9/6/06 Secondary Prevention Secondary Prevention Those measures provided to individuals to identify and treat asymptomatic persons who have already developed risk factors or pre-clinical disease but in whom the condition has not become clinically apparent. 9/6/06 Tertiary Prevention Tertiary Prevention Those measures provided to individuals to treat symptomatic persons who have already developed the disease to prevent progression or complications associated with the disease. 9/6/06 Screening Screening The presumptive identification of unrecognized disease or defect by the application of tests, examinations, or other procedures which can be applied rapidly Sorts out apparently well persons who probably have a disease from those who probably do not. 9/6/06 What Screening Is Not : What Screening Is Not : Not intended to be diagnostic. Does not differentiate between unrecognized symptomatic disease and pre-symptomatic disease.
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Michael Roybal, M. D., M.P.H Screening: Issues and Controversies in Implementing Programs in Disease Detection 3 9/6/06 Examples of Screening Tests Examples of Screening Tests Mammogram Cholesterol Testing Papanicolaou Smear Tuberculosis Skin Testing 9/6/06 Biostatistics Biostatistics Sensitivity Specificity Incidence Prevalence Positive and Negative Predictive Value 9/6/06 Sensitivity Sensitivity Proportion of people with the condition/disease in question who have a positive screening test for that condition/disease. Positive In Disease (PID) 9/6/06 Specificity Specificity Proportion of people without the condition/disease in question who have a negative screening test for that condition/disease. Negative In Health (NIH)
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Michael Roybal, M. D., M.P.H Screening: Issues and Controversies in Implementing Programs in Disease Detection 4 9/6/06 Characteristics of A Screening Characteristics of A Screening Test Test Condition Present Condition Absent Positive Test a b a+b Negative Test c d c+d a+c b+d a+b+c+d a = true positive b = false positive c = false negative d = true negative
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This note was uploaded on 02/28/2010 for the course HP 200 taught by Professor Roybal during the Fall '05 term at USC.

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HP_200_Screening - Michael Roybal, M. D., M.P.H...

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