If a test is reliable, it gives consistent results with repeated tests. Valid (distinguishes diseased & non-diseased people).There is controversy about the role of PSA (prostate-specific antigen) testing to identify prostate cancer.Screening is very inefficient when the prevalence of the condition is low.Even when lung cancer is detected by screening, earlier treatment does not seem to prolong survival substantially.If they become symptomatic, the gallbladder can be removed, and the delayed treatment generally causes no problem. Many people with gallstones remain asymptomatic and do not require surgery.However,screening is not always appropriate : When the prevalence of disease in the DPCP is relatively high.īy these criteria, blood pressure screening to detect and treat hypertension is an ideal circumstance for screening.When treatment before symptoms occur is more effective than treatment that is delayed until symptoms appear.The disease is serious (e.g., cervical cancer).We hope that detection of disease in the DPCP will lead to earlier treatment and that this, in turn, will lead to a better outcome. The time interval between possible detection by screening and later detection after symptoms is the 'detectable pre-clinical phase' or DPCP. However, disease frequently begins long before symptoms occur, and even in the absence of symptoms there may be a point at which the disease could be detected by a screening test. Without screening, diagnosis of disease only occurs after symptoms develop. Discuss the potential harms of screening.Explain what is meant by 'length time bias'.Explain what is meant by 'lead time bias'.Explain how predictive value is influenced by prevalence of disease.Explain how increasing or decreasing the cut-off value used to identify an abnormal test result influences sensitivity and specificity of the screening test.Define, calculate, and interpret the sensitivity, specificity, positive predictive value and negative predictive value of a screening test.Define 'detectable pre-clinical phase' of disease.Define what is meant by the reliability of a screening test, and list the factors that influence reliability.List the characteristics of a good screening test.Identify which types of diseases are appropriate for screening.Learning ObjectivesĪfter completing this module, the student will be able to: More recently, there has been controversy about whether PSA (prostate-specific antigen) screening should be used at all in men. There has been much controversy regarding the age at which routine mammography screening should begin in order to screen for breast cancer.

Sequential testing ppv