IRWIN ARAS
Community Medicine Department
FMUH
DEFINITION
WHO-Regional Committee for
Europe, 1957:
Attempts to identify a disease that
is clinically unclear using certain
examinations or other procedures
which can be used to quickly
distinguish those who appeared
healthy but have the nature of really
sick or healthy.
DEFINITION
Mc Keown, 1968:
Medical investigations carried out not by
the patient preference in getting advice for
specific complaints
Detection of emerging diseases in a
healthy population
Application of the test to people who are
asymptomatic with the aim to group them
into groups which may suffer from certain
diseases
THE NATURE OF SCREENING
PREPATOGEN PATHOGEN
ESIS ESIS
SUSCEPTIBI ADAPTATI EARLY CLINIC
LITY ON DISEASE
EARLY PROTECTION OF
DISEASE
Screening should be
performed here
Aims of Screening
General
Detect the disease as early as possible so as to
reduce morbidity and mortality and improve
quality of life
Specific
Research / survey
Protection of public health
Prescriptive (for the advice / instructions given)
Lowering morbidity and mortality
Improving quality of life
Given the scale of the problem
Disease Criterias
1. Prevalence quite "high".
2. Morbidity and / or mortality
meaningful if untreated.
3. There are effective therapies,
4. Beneficial early treatment outweigh
further cases.
example;
5. TB with tuberculin test; feasible
6. Ca lung with chest X-ray; not
feasible
CONDITION OF SCREENING
Measur Positive TP +
ement TP FP
FP
of
screeni Negativ FN +
ng tool e FN TN
TN
TP + FP +
N
FN TN
Validity Value
Criterias for assess a Screening Test;
Validity: the The
ability ofcan
test a test to determine where
predict
people who have a disease
perfectly/ and who are not
completely;
Where is all that +
Valid if: based on ST is really
sick
Where is all that -
based on ST is really
not sick
Components of validity:
Sensitivity
Specifity
Validity Value
Measurement
of the Gold
Standard
Positive Negativ Total
Sensitivity: e
= TP/(TP + FN)
Measur Positive TP +
ement TP FP
FP
of
screeni Negativ
Specifity: ng tool e FN TN
FN +
TN
= TN/(TN + FP) TP + FP +
N
FN TN
Paps Positiv
Smea e 69 131 200
r
Negati
ve 1 2.049 2.050
70 2.180 2.250