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27 Cards in this Set
- Front
- Back
Three types of bias commonly observed in studies evaluating effectiveness of screening tests |
lead-time bias, length bias, overdiagnosis
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occurs when a screening test leads to earlier identification of a condition, and an apparent improvement in 5-year survival, but does not actually result in improved mortality
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lead-time bias
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occurs when the variable rate of progression of a disease is not accounted for
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length bias (slow-progressing cancer, for example)
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dentification of cancers that are not destined to progress, thereby inflating survival statistics
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overdiagnosis
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2 questions for depression screening
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over the past 2 weeks, have you felt depressed? ... felt little interest or pleasure in doing things?
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BP screening
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all adults >18 (USPSTF); JNC 7- q2y if BP <120/80; q1y if 120-139/80-89
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screening tests for pregnant women (USPSTF) (4)
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HIV, hep B, syphilis, asymptomatic bacteriuria
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screening tests for persons at risk for STIs (USPSTF) (4)
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HIV, hep C, chlamydia, gonorrhea
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periodic screening recommended by USPSTF
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HL, osteoporosis, AAA; breast CA, cervical, colon cancer
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NCEPATPIII recommendation for dyslipidemia screening
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fasting lipid q5y in all adults >20y with normal initial lipid
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USPSTF recommendations for type 2 DM screening
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asymptomatic adults with sustained BP >135/80
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NOTE: Diabetes Association recommends screening all adults age 45 years and older without risk factors
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and all adults with a BMI of equal to or greater than 25 who have one or more of the following risk factors: gestational diabetes, hypertension, hyperlipidemia, and family history of type 2 diabetes in a first-degree relative.
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Appropriate screening tests for DM (3)
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fasting plasma glucose level, hemoglobin A1c level, or a 2-h, 75-g oral glucose tolerance test
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USPSTF recommends screening for osteoporosis
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all women >65; younger women with elevated risk
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USPSTF recommends screening for AAA
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all men between 65-75 who ever smoked
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definition of USPSTF for "ever smoked"
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100 lifetime cigarettes
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The USPSTF recommends against screening for these conditions: (4)
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carotid artery stenosis, COPD, hereditary hemochromatosis, PAd
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CDC recommendations for HIV screening
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all persons between the ages of 13 and 64 years should be screened for HIV infection
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CDC recommendations for Hep C screening
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persons at increased risk of infection (history of illicit injection drug use, history of receiving clotting factors before 1987 or blood products or organs before 1992, or on chronic hemodialysis at any time) + 1 time screening for baby boomers regardless of risk factors
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define baby boomers
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born 1945-1965
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USPSTF recommendation for chlamydia screening
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all women 24 years of age or younger who are sexually active and all women older than 24 years who are at increased risk of infection (history of sexually transmitted infection [STI], new or multiple sexual partners, inconsistent condom use, or exchanging sex for drugs or money)
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USPSTF recommendation for gonorrhea screening
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sexually active women who are at increased risk of infection (same risk factors as for chlamydial infection).
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USPSTF recommendation for asmptomatic bacteriuria
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(urine culture) pregnant women at 12 to 16 weeks' gestation or at the first prenatal visit, whichever comes first
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the only available breast cancer screening modality that has been shown to reduce mortality
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mammography
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USPSTF recommendation for mammography screening
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biennial screening mammo for women 50-74; should be individualized between 40-49
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Pap smear shows atypical squamous cells of undet significance - options?
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referring for colposcopy, obtaining HPV DNA testing and then referring for colposcopy if positive, or repeating the Pap smear in 6 to 12 months.
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Pap smear shows abnormal smear, next step?
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colposcopy
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