CH4txtDIAGNOSTICS - MPET 2008 CH4 diagnostics-1 DIAGNOSTICS Diagnostic tests are being used in a variety of applications such as diagnosis in the

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MPET 2008 CH4 diagnostics - 1 - DIAGNOSTICS « Diagnostic tests » are being used in a variety of applications, such as diagnosis in the strict sense of the word, follow-up and monitoring, screening and therapy. Even when the same parameter is sometimes determined in these distinct situations, still it is necessary to distinguish between them, since other requirements might be more or less important depending on the application. Diagnosis in the strict sense: here one aims at determining which disease, which subtype, which degree of severity of this disease a patient is suffering from, and this starting from a certain pattern of complaints (Nl. Klachten) and/or signs (Nl. Tekenen) [signs=can be objectivated e.g. swelling] and/or symptoms (Nl. Symptomen) [symptoms=subjective e.g. pain] obtained during anamnesis (Nl. anamnese) [anamnesis= disease history obtained by questioning the patient] and clinical examination (e.g. reflex testing, auscultation, blood pressure and pulse measurement] Follow-up: here one investigates the effect of a treatment [e.g. does the statin indeed lowers LDL]. In monitoring the follow-up is quantitative, in view of feedback to the treatment. So, one can determine plasma levels of drugs with a narrow therapeutic margin, adjust insulin therapy or modify the dose of chemotherapeutic agents in cancer therapy in view of the side effects. Screening: by definition, screening is done in a-symptomatic persons, without indications that a particular disease is present. The aim is early detection of a disease, before symptoms or signs are present. This can be done in the complete population, in risk groups or in patients (e.g. pre-operative screening). The aim can be to prevent therapy accidents, obtain a better prognosis (e.g. cervix carcinoma [NL. Baarmoederhalskanker] ), or to protect public health (e.g. tuberculosis).
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MPET 2008 CH4 diagnostics - 2 - Therapy : to administer a correct therapy sometimes “diagnostic tests” are necessary. Examples are determination of blood group before blood transfusion, HLA tests before transplantation, assessment of kidney function before the administration of certain drugs, pharmacogenetic tests to predict the response towards particular chemotherapeutic agents or the sensitivity towards side effects or the pharmacokinetic behavior. Also the determination of the sensitivity/resistance of bacteria towards particular antibiotics is using increasingly molecular tests. Diagnostic tests are used in the first place to guide the “medical action” . This “medical action” should be viewed in the broadest sense and includes
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This note was uploaded on 05/28/2010 for the course WE BIBI000000 taught by Professor Johangrooten during the Spring '10 term at Ghent University.

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CH4txtDIAGNOSTICS - MPET 2008 CH4 diagnostics-1 DIAGNOSTICS Diagnostic tests are being used in a variety of applications such as diagnosis in the

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