screening
Introduction
Examinations aimed at detecting medical conditions early in their course or before they become symptomatic, often with the purpose of implementing treatment that will prevent or ameliorate the problem.
* see health maintenance for recommended screening
Principle
Effective screening involves affirmative answers to the following questions:
- Is the condition sufficiently common?
- Will the condition result in significant morbidity & mortality if left untreated?
- Is there a reliable* & sensitive screening test?
- Does it lead to accurate diagnosis?
- Does detection during the asymptomatic phase result in a beneficial intervention? i.e. Is there effective treatment?
* specificity NOT explicity included, but adds an additional element if cost-effectiveness is to be considered
screening based on clinical guidelines needs to be individualized; shared decision-making should be documented & should include rationale for refusing recommended screening[4]
presenting evidence to patients regarding harms vs benefits for low-value screenings* infrequently alters their choice[3]
* screening for prostate cancer in men age 50-69 years
* screening for osteoporosis in low-risk women age 50-64 years
* screening for colon cancer in elderly age 76-85 years
Complications
- incidental findings may lead to cascades of care resulting in psychological harm, financial burden, physical harm, & death[5]
Notes
- see health maintenance for recommended screening
More general terms
More specific terms
- cardiac risk assessment
- genetic screening
- geriatric screening
- neonatal screening
- screening for abdominal aortic aneurysm (AAA)
- screening for alcohol abuse
- screening for anxiety
- screening for cancer
- screening for cardiovascular disease
- screening for congenital hip dislocation
- screening for dementia; screening for cognitive impairment; screening for Alzheimer's disease
- screening for depression (includes depression assessment tools)
- screening for developmental disorder
- screening for dyslipidemia (screening for hyperlipidemia)
- screening for dysphagia
- screening for dyspnea in palliative care
- screening for ear disease
- screening for endocrine disease
- screening for eye disease
- screening for gout
- screening for heart disease
- screening for heart failure
- screening for hematologic disease
- screening for hepatitis C
- screening for high-risk sexual behavior
- screening for HIV1
- screening for hyperhomocysteinemia
- screening for illicit drug use
- screening for infection
- screening for injection drug abuse
- screening for malnutrition
- screening for nephropathy
- screening for neurologic disease
- screening for obesity
- screening for obstructive sleep apnea
- screening for osteoporosis
- screening for peripheral arterial disease
- screening for poisoning (toxicity)
- screening for respiratory tract disease
- screening for rheumatologic disease
- screening for skin disease
- screening for tobaccoism (tobacco use)
- screening for urinary incontinence
- screening for urogenital disease
- screening for vitamin deficiency
- Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP)
- Screening Tool to Alert doctors to Right Treatment (START)
- STarT Back Screening Tool
Additional terms
References
- ↑ Journal Watch 24(18):124, 2004 Massachusetts Medical Society
- ↑ van den Bruel A et al People's willingness to accept overdetection in cancer screening: population survey. BMJ 2015;350:h980 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25736617 <Internet> http://www.bmj.com/content/350/bmj.h980
- ↑ 3.0 3.1 Sheridan SL, Sutkowi-Hemstreet A, Barclay C et al A Comparative Effectiveness Trial of Alternate Formats for Presenting Benefits and Harms Information for Low-Value Screening Services: A Randomized Clinical Trial. JAMA Intern Med. 2016 Jan 1;176(1):31-41. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26720730
- ↑ 4.0 4.1 Medical Knowledge Self Assessment Program (MKSAP) 17, 18 American College of Physicians, Philadelphia 2015, 2018
- ↑ 5.0 5.1 Ganguli I, Simpkin AL, Lupo C et al. Cascades of care after incidental findings in a US national survey of physicians. JAMA Netw Open 2019 Oct 2; 2:e1913325 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31617925 Free PMC Article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2752991