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IMPORTANT CONCEPTS

SCREENING



Reports on screening will often use many of the same concepts as reports on therapy.  It will be important to understand such concepts as Absolute Risk Reduction, Relative Risk, and Number Needed to Treat.  All of these concepts are discussed in the section on Important Concepts as relates to therapy .  

However, when considering an article on screening, there are also measures of the quality of the test itself that you need to take into consideration.  In particular, you will want to be aware of concerns related to Prevalance, Sensitivity, and Positive Predictive Value.  These concepts are discussed in the section on Important Concepts as relates to diagnosis.

You will also want to take into consideration how bad the disease can get and whether the lead time provided by early detection from screening will affect the progression and duration of a disease.  Issues of risk and disease progression are discussed in the section on Important Concepts as relates to prognosis .


Basically, the process of deciding whether to screen follows the following format:


1) Is the Prevalance of the disease high enough in the target population to warrant the time and expense of screening?

2) Does a therapy exist which will significantly reduce the risk of disease?

3) If not, will early screening effect the duration/severity of the disease?

4) Is the screening test itself sufficiently sensitive to catch the disease so that treatment may progress?


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