7051 - Ethical issues and cancer screening Efficacy The...

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Ethical issues and cancer screening
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Efficacy The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally the determination of efficacy is based on the results of a randomised controlled trial. Last JM (ed). A Dictionary of Epidemiology. Third edition New York: Oxford University Press, 1995.
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Effectiveness The extent to which a specific intervention, procedure, regimen, or service, when deployed in the field in routine circumstances , does what it is intended to do for a specified population. Last JM (ed). A Dictionary of Epidemiology. Third edition New York: Oxford University Press, 1995.
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Assessing the Efficacy of Screening Lead-time bias Length bias Selection bias Overdiagnosis bias
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Screened X X death Not screened X X death Disease begins Screen diagnosis Signs/symptoms
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Screened X X death Not screened X X death Disease begins Screen diagnosis Signs/symptoms Survival time
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Lead time bias Screening advances the date of diagnosis and thereby extends the interval between diagnosis and death even if the time of death is unchanged. People whose disease was detected by screening will appear to have longer survival than people diagnosed in the normal way.
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__________ ____________________________ _______________ __________ ___________ ______ ________________________________ ________ _____________ ________ ____ _______ _________ ____________________ _____ _______ ___________ ___________ _________________________ _____________ Horizontal lines represent the pre-symptomatic screen-detectable phase in various individuals
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screen screen __________ ____________________________ _______________ __________ ___________ ______ ________________________________ ________ _____________ ________ ____ _______ _________ ____________________ _____ _______ ___________ ___________ _________________________ _____________
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This note was uploaded on 02/23/2012 for the course SCI 310 taught by Professor Staff during the Fall '10 term at Rutgers.

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7051 - Ethical issues and cancer screening Efficacy The...

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