TAILIEUCHUNG - Lecture Evaluating Screening tests

This lecture includes these contents: Overview and definitions, observational studies of screening, randomized trials of screening, conclusion – ecologic view,. Invite you to consult this lecture. | Thomas B. Newman, MD, MPH Andi Marmor, MD, MSEd Outline Overview and definitions Observational studies of screening Randomized trials of screening Conclusion – ecologic view What is screening? Common definition: “Testing to detect asymptomatic disease” Better definition*: “Application of a test to detect a potential disease or condition in people with no known signs or symptoms of that disease or condition” *Common screening tests. David M. Eddy, editor. Philadelphia, PA: American College of Physicians, 1991 What is screening? Common definition: “Testing to detect asymptomatic disease” Better definition*: “Application of a test to detect a potential disease or condition in people with no known signs or symptoms of that disease or condition” *Common screening tests. David M. Eddy, editor. Philadelphia, PA: American College of Physicians, 1991 What is screening? Common definition: “Testing to detect asymptomatic disease” Better definition*: “Application of a test to detect a potential disease or condition in people with no known signs or symptoms of that disease or condition” “ Condition” includes a risk factor for a disease *Common screening tests. David M. Eddy, editor. Philadelphia, PA: American College of Physicians, 1991 Screening Spectrum Risk factor Recognized symptomatic disease Presymptomatic disease Unrecognized symptomatic disease Fewer people recognized and treated Easier to demonstrate benefit Less potential for harm Examples of Screening Along the Spectrum Risk factor for disease: Hypercholesterolemia, hypertension Presymptomatic disease: Neonatal hypothyroidism, syphilis, HIV Unrecognized symptomatic disease: Vision and hearing problems in young children; iron deficiency anemia, depression Somewhere in between?: Prostate cancer, breast carcinoma in situ, more severe hypertension Screening for risk factors Relationship between risk factor, disease and treatment difficult to establish Does test predict disease? Does treatment

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• Lecture Evaluating Screening tests
• Overview and definitions
• Observational studies of screening
• Randomized trials of screening
• Conclusion ecologic view