SCREENING

Putri Eyanoer, MD., Ms.Epi., Ph.D.

Prepared by. Putri Eyanoer

DEFINITIONS
the presumptive identification
of unrecognized disease or
defect by the application of
test, examinations or other
procedures which can be
applied rapidly to sort out
apparently well persons who
probably have a disease
from those who probably
not.

Prepared by. Putri Eyanoer

DEFINITIONS
Biologic onset of
the condition

Sign and symptoms

of disease

Pathologic evidence of disease

detectable by screening

Early detection of
preclinical disease
in asymptomatic
persons

Health care sought

Treatment of disease

Diagnosis of disease

Prepared by. Putri Eyanoer

DEFINITIONS
A screening test is NOT intended to be diagnostic.
Persons with positive or suspicious findings must be referred to
their physicians for diagnostic & necessary treatment

Prepared by. Putri Eyanoer

DEFINITIONS
More
specific
test

Performed
repeated
test
Prepared by. Putri Eyanoer

TARGET DISEASES
1. BACTERIAL INFECTION (TB, LEPRAE)
2. VIROLOGICAL INFECTION (HEPATITIS)
3. NIN INFECTIOUS DISEASE
4. AIDS

Prepared by. Putri Eyanoer

IMPORTANT CHARACTERISTICS

DETERMINE
BY
SENSITIVITY
AND
SPECIFICITY

V
VALIDITY

REPEAT
ABILITY

AMOUNT OF
DISEASE
DETECTED
IN A
POPULATION

RELIABILITY

YIELD

Prepared by. Putri Eyanoer

VALIDITY
The extent to which the test measures
what it is supposed to measure
1.

Sensitivity
The ability of a test to identify correctly
those who have the disease

2.

Specificity
The ability if a test to identify correctly
those who do not have the disease

Prepared by. Putri Eyanoer

RELIABILITY (PRECISION)
A+A=2As

A+A=2As

one that gives consistent results

when the test is performed more
than once on the same individuals
under the same condition
A+A=2As

A+A=2As

Factors affecting consistency:

Variation inherent in the method
Observer variation / observer error
Inter-observer variation
Intra-observer variation

A+A=2As

Prepared by. Putri Eyanoer

RELIABILITY (PRECISION)
Reducing variations by:
Standardization of procedures
Intensive training period for all observer
Work periodic check
Using two or more observer making
independent observations

Prepared by. Putri Eyanoer

yield
the amount of previously
unrecognized disease that is
diagnosed and brought to treatment
as a result of the screening

Factors affecting are:

Sensitivity of the test
Prevalence of unrecognized disease
Extent of previous screening
Health behavior

Prepared by. Putri Eyanoer

SCREENING INDICATORS
COST
INSTRUMENTS
RAPID RESULT OF SCREENING TEST
USERS FRIENDLY; FAMILIAR
ALTERNATIVE TREATMENT FOR POSITIVE RESULT
OTHER POSSIBLE DIAGNOSTIC TEST/INSTRUMENT

Prepared by. Putri Eyanoer