As per John M. Last (1988) Epidemiology is the study of the distribution and determinants of health related states or events in specified populations, and the application of this study to the control of health problems.
As per John M. Last (1988) Epidemiology is the study of the distribution and determinants of health related states or events in specified populations, and the application of this study to the control of health problems.
The unusual occurrence in a community or region of disease, specific health related behaviour (eg. Smoking) or other health related events (eg. Traffic accidents) clearly in excess of “expected occurrence.
Screening for disease or Early detection of disease is detecting a disease at an earlier stage than would usually occur in standard clinical practice.
This denotes detecting disease at a pre-symptomatic stage, at which point the patient has no clinical complaint ( no symptoms or signs) and therefore no reason to seek medical care for the condition
Early detection of disease is beneficial and that intervention at an earlier stage of the disease process is more effective or easier to implement than a later intervention
The STUDY of the DISTRIBUTION & DETERMINANTS of HEALTH-RELATED STATES in specified POPULATIONS, and the application of this study to CONTROL of health problems.
Social and Preventive Medicine Classroom discussion topic on types of Epidemiological study designs available.
sole reference is Park text book 20th edition
The unusual occurrence in a community or region of disease, specific health related behaviour (eg. Smoking) or other health related events (eg. Traffic accidents) clearly in excess of “expected occurrence.
Screening for disease or Early detection of disease is detecting a disease at an earlier stage than would usually occur in standard clinical practice.
This denotes detecting disease at a pre-symptomatic stage, at which point the patient has no clinical complaint ( no symptoms or signs) and therefore no reason to seek medical care for the condition
Early detection of disease is beneficial and that intervention at an earlier stage of the disease process is more effective or easier to implement than a later intervention
The STUDY of the DISTRIBUTION & DETERMINANTS of HEALTH-RELATED STATES in specified POPULATIONS, and the application of this study to CONTROL of health problems.
Social and Preventive Medicine Classroom discussion topic on types of Epidemiological study designs available.
sole reference is Park text book 20th edition
From Wall Street to Love Street workshop at IstanbulThe Socializers
Presented at the "Hello, I Love You" conference - http://www.marketingsummitistanbul.com - in Istanbul, Turkey on Dec 8, 2011. Eleftherios Hatziioannou and Nathaniel Hansen.
The 21-Day Purpose Challenge Results (8/2015)Brandon Peele
The 21-Day Purpose Challenge was delivered in August of 2015, by Brandon Peele and the Planet Purpose team. Dr. Gleb Tsipursky, PhD, Professor at Ohio State University, and Planet Purpose Science Advisor, administered the Meaning and Purpose Questionaire evaluating the self-reported purpose meaning before and after having taken the Challenge. Most promising was the 1.91 differential improvement (on a scale of 1-10) in the agreement with the statement "I am satisfied with the sense of meaning and purpose in my life."
Background:
Planet Purpose http://planetpurpose.org
The Purpose Revolution http://igg.me/at/purposerevolution
Intentional Insights http://intentionalinsights.org/
Seminar cocreatie en opsporing bij de Politie Academie: De politie is voor de opsporing van daders van misdrijven vaak afhankelijk van de medewerking van de burger. Dat is eigenlijk nooit anders geweest, burgerparticipatie bij het politiewerk is van alle tijden. Binnen de politie wordt voortdurend geëxperimenteerd met innovatieve manieren om de burger bij het oplossen van misdrijven te betrekken. Cocreatie is zo'n specifieke vorm van burgerparticipatie. Bij cocreatie werken politie en burgers gezamenlijk aan een oplossing die voor beide partijen waarde creëert. Hierachter zit het idee dat de burger de veiligheid krijgt die hij verdient en waaraan hij zelf meewerkt. Cocreatie kenmerkt zich door een vergaande vorm van samenwerking waarbij burgers steeds meer invloed hebben op de aanpak van criminaliteit. Maar hoe kun je dit bereiken? Het contact van de politie met burgers is traditioneel informerend en zendend van aard, dus eenrichtingsverkeer. Dit is anno 2012 achterhaald, de politie c.q. overheid moet een manier vinden om contact met burgers te krijgen om in dialoog te treden. Dit betekent geen een- maar tweerichtingsverkeer.
3 New Facebook Promotional Engagement ModelsTom Edwards
The white paper outlines three new promotional engagement models that Facebook now supports based on recent changes to the promotional guidelines. It can be used as a resource when mapping client objectives to the ideal promotional engagement model, including making the call between an app vs. responsive News feed strategy or how hashtag promotions differ on Facebook vs. other platforms such as Twitter, Instagram and Vine.
A presentation from Key-Competences Conference, Baia Mare 25-27 Mai 2007. The published paper, in Romanian, being available in my account at Academia.edu .
final presentation for my MA enquiry on:
Evaluating the Impact of an ELearning resource upon the attainment of Year 8 pupils during their Design and technology home learning project.
Screening is the testing of apparently healthy populations to identify previously undiagnosed diseases or people at high risk of developing a disease.
Screening aims to detect early disease before it becomes symptomatic.
Screening is an important aspect of prevention, but not all diseases are suitable for screening.
Application of relatively simple & rapid test to a large number of apparently healthy people in order to classify them as likely or unlikely to have the disease.
Screening is a process by which we identify the people who have the disease from those who don't have the disease by using specific tests.
It's helps in identifying the disease even before the pre symptomatic period.
It can eliminate the disease my early diagnosis or decrease the damage it causes to one person's health by early treatment .
Diagnostic, screening tests, differences and applications and their characteristics, four pillars of screening tests, sensitivity, specificity, predictive values and accuracy
Diseases that are spread by arthropod or small animal vectors.
Vectors act as the main mode of transmission of infection from one host to another, & as such form an essential stage in the transmission cycle.
Zoonoses : are infections which are naturally transmitted between vertebrate animals and people.
The term zoonosis'Derived from the Greek
ZOON (animals) and NOSES (diseases)
People, animals, birds, arthropods and the inanimate environment are all involved in cycles of zoonotic infection
There is no specific format But every institute have their own guideline and instructions,
In preparing Synopsis you should restrict the size of your research area in line with the length of dissertation/Research paper/Theses required by College/University
Lecture for Post and Undergraduate.
From the past two decades Non Communicable diseases are increasing in both developing and developed countries due to which developing are experiencing double burden of diseases.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
2. What is Screening
• Screening is the testing of apparently healthy
populations to identify previously undiagnosed diseases
or people at high risk of developing a disease.
• Screening aims to detect early disease before it
becomes symptomatic.
• Screening is an important aspect of prevention, but not
all diseases are suitable for screening.
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DR MUHAMMAD TAUSEEF JAVED SIMS
3. Definitions
1. Screening program -- comprehensive disease control
activity based on the identification and treatment of
persons with either unrecognized disease or
unrecognized risk factors for disease.
2. Screening test -- specific technology (survey
questionnaire, physical observation or measurement,
laboratory test, radiological procedure, etc.) used to help
identify persons with unrecognized disease or
unrecognized risk factors for disease.
Definitions
3
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4. Definitions
3. Primary prevention -- disease control approach based on the
elimination or reduction of risk factors for disease. Primary
prevention aims to prevent the occurrence of disease. Primary
prevention may use screening tests to identify persons with risk
factors.
4. Secondary prevention -- disease control approach based on the
active identification and treatment of persons with unrecognized
disease. Secondary prevention aims to prevent the occurrence of
adverse outcomes from disease (such as fatal outcomes), without
necessarily reducing the occurrence of disease. Secondary
prevention must screen to identify persons with unrecognized
disease
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5. Generalities
1. Screening often implies a public health related
activity involving asymptomatic or healthy
subjects coming from the general population.
2. Case-finding refers to special clinical efforts to
recognize disease among persons who
consult a health professional.
Generalities
5
DR MUHAMMAD TAUSEEF JAVED SIMS
6. Screening, Case financing and Diagnostic
test
Terminology
for testing
Target Persons
Screening Apparently healthy individuals who
are not seeking health care
Case-finding To detect disease in individuals
seeking health care for other
reasons
Diagnostic
tests
To confirm or disprove the existence
of disease in patients presenting
with complaints (Symptoms & signs
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DR MUHAMMAD TAUSEEF JAVED SIMS
7. The Principles of Screening
• The choice of disease for which
to screen;
• There should be longer latent or
early a symptomatic stage
• Facilities for confirmation of
diagnosis must be available
• The availability of a treatment
for those found to have the
disease;
• The relative costs of the
screening.
7
DR MUHAMMAD TAUSEEF JAVED SIMS
8. • The disease must be an important health problem.
• There should be a recognizable latent or early symptomatic
stage.
• The natural history of the disease, including latent to
declared disease, should be adequately understood.
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10. • There should be a suitable test or examination.
• The test should be acceptable to the population.
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11. Examples of screening
• Screening the healthy people for hypertension
• Screening healthy adults for diabetes
• Screening of high-risk population for HIV/AIDS and Hepatitis
• Screening of pregnant ladies for anemia/ Cervical cancers
etc
11 DR MUHAMMAD TAUSEEF JAVED SIMS
12. Screening and diagnostic tests
Screening tests Diagnostic tests
Conducted on apparently
health population
Conducted on sick or with
some indications
Applied to groups or
communities
Applied to the patients under
consideration
The initiative comes from the
investigator or some agency
Initiative based on patient
complaints
The objectives are
predominantly preventive
The objective is to modify the
treatment on basis of tests
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DR MUHAMMAD TAUSEEF JAVED SIMS
13. Screening and diagnostic tests
Screening tests Diagnostic tests
Based on one criterion or cut-
off point
Based on clinical evaluation of
signs and symptoms
Less expensive More expensive
Less accurate More accurate
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14. True Disease Status
Screening
Test
Positive Negative Total
Positive True Positives
(TP)
False Positives
(FP)
TP+FP
Negative False Negatives
(FN)
True Negatives
(TN)
FN+TN
Total TP+FN FP+TN TP+FP+FN+TN
Outcomes of a Screening Test
14 DR MUHAMMAD TAUSEEF JAVED SIMS
15. • There should be an acceptable treatment for the patients
with recognized disease.
• There should be facilities for diagnosis
and treatment should be available.
• There should be an agreed policy on whom to treat as
patients.
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16. • The cost of case finding (including diagnosis and treatment of
patients diagnosed) should be economically balanced in relation to
possible expenditure on medical care as a whole.
• Case finding should be a continuing process and not a "once for all"
project.
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17. Uses of Screening
Case detection Objectively done to identify the
unrecognized diseases e.g.
neonatal screening
Control of disease Objectively done to identify the
diseases to prevent transmission
in the community
Epidemiology /
Research
Initial screening to identify the
prevalence subsequent for
research purpose
Educational
Opportunities
Objectively done for health
education purposes e.g. screening
of diabetics
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18. Screening Strategies
Mass
Screening
Screening of whole population or
subgroups of population e.g. Screening
of all adults for tuberculosis
High risk or
Selective
Screening is applied to selectively to
high-risk for a particular health problem
or disease
Multiphase
Screening
The people are subjected to more than
one screening test. First screening for
identification of suspect and second for
confirmation of diseases
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19. Latent or Incubation period
Time period lapse between the start of the
disease process up to the appearance of
sign and symptoms of disease.
Disease
onset
Possible
detectio
n
Final
critical
point
Usual time
of
diagnosis
Latent/ incubation
period
outcom
e
A B C D
19
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20. • Time between possible detection and the usual time of
diagnosis by signs and symptoms is the “Lead Time”
• Time between first possible detection and the finial critical
detection is the “Screening Time”
Screening time and lead time
Disease
onset
Possible
detectio
n
Final
critical
point
Usual time
of
diagnosis
outcom
e
Screening
time
Lead time
A B C D
20
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21. Concept of Latent period, Screening
time and Lead time
Disease
onset
Possible
detection
Final critical
point
Usual time
of
diagnosis
Latent/ incubation
period
outcome
Disease
onset
Possible
detection
Final
critical
point
Usual time of
diagnosis
outcome
Screening
time
Lead time
A B C D
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22. Summary
• Screening is the testing of apparently healthy populations
to identify previously undiagnosed diseases or people at
high risk of developing a disease.
• Principles of Screening: disease, test, treatment and cost.
What is the next step?
Define the validity of the screening test and
put screening to use in the population.
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23. Terms Related to
Screening Tests
• Validity - relates to accuracy (correctness)
• Reliability - repeatability
• Yield - the # of tests that can be done in a time period
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24. Terms Related to Screening Tests (cont’d)
• Sensitivity - ability of a test to identify those who
have disease
• Specificity - ability of a test to exclude those who
don’t have disease
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25. Terms Related to Screening Tests
(cont’d)
• Tests with dichotomous results – tests that give either
positive or negative results
• Tests of continuous variables – tests that do not yield
obvious “positive” or “negative” results, but require a
cutoff level to be established as criteria for
distinguishing between “positive” and “negative”
groups
25
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26. How will you test the accuracy of
screening test?
• Identify the screening test to be evaluated
• Identify the confirmatory test for counter testing also
known as “Gold Standard Test”
• Screened the population of interest by screening test
• Apply counter test or Gold Standard Test to all the
positive and negative identify by screening test
• Determine the accuracy by 2x2 Table analysis
26
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27. Examples of Screening and Gold
Standard
Disease Screening test Gold Standard or
Counter test
Diabetes Blood Glucose Glucose tolerance
test
Brain tumor EEG CT Scan
Breast
cancer
Mammography FNA
(histopathology)
Tuberculosi
s
Tuberculin test Sputum for AFB
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28. Sensitivity
Dis. Yes Dis. No Total
Dis.
yes
a
(True
positive)
b
(False
Positive)
a + b
Dis. No c
(False
Negative)
d
(True
Negative)
c + d
Total a + c b + d Grand total
Sensitivity =
a
a + c
True positive
True positive + False
Negative
X 100
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29. Specificity
X 100
Dis. Yes Dis. No Total
Dis.
yes
a
(True
positive)
b
(False
Positive)
a + b
Dis. No c
(False
Negative)
d
(True
Negative)
c + d
Total a + c b + d Grand total
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30. Percentage of false Positive
Percentage false
positive =
b
b + d
Dis. Yes Dis. No Total
Dis.
yes
a
(True
positive)
b
(False
Positive)
a + b
Dis. No c
(False
Negative)
d
(True
Negative)
c + d
Total a + c b + d Grand total
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31. Percentage of false negative
X 100
Dis. Yes Dis. No Total
Dis.
yes
a
(True
positive)
b
(False
Positive)
a + b
Dis. No c
(False
Negative)
d
(True
Negative)
c + d
Total a + c b + d Grand total
31
DR MUHAMMAD TAUSEEF JAVED SIMS
32. Predictive value of positive test (PPV)
a
a + b
True Positive X 100
Dis. Yes Dis. No Total
Dis.
yes
a
(True
positive)
b
(False
Positive)
a + b
Dis. No c
(False
Negative)
d
(True
Negative)
c + d
Total a + c b + d Grand total
32
DR MUHAMMAD TAUSEEF JAVED SIMS
33. Predictive value of Negative test (NPV)
Dis. Yes Dis. No Total
Dis.
yes
a
(True
positive)
b
(False
Positive)
a + b
Dis. No c
(False
Negative)
d
(True
Negative)
c + d
Total a + c b + d Grand total
33
DR MUHAMMAD TAUSEEF JAVED SIMS
34. Apparent or false prevalence
False/apparent
prevalence =
a +
G. total
Dis. Yes Dis. No Total
Dis.
yes
a
(True
positive)
b
(False
Positive)
a + b
Dis. No c
(False
Negative)
d
(True
Negative)
c + d
Total a + c b + d Grand total
34
DR MUHAMMAD TAUSEEF JAVED SIMS
35. True Prevalence
a +c
G. total Total patient Screened
X
Dis. Yes Dis. No Total
Dis.
yes
a
(True
positive)
b
(False
Positive)
a + b
Dis. No c
(False
Negative)
d
(True
Negative)
c + d
Total a + c b + d Grand total
35
DR MUHAMMAD TAUSEEF JAVED SIMS
36. Accuracy of the test
Dis. Yes Dis. No Total
Dis.
yes
a
(True
positive)
b
(False
Positive)
a + b
Dis. No c
(False
Negative)
d
(True
Negative)
c + d
Total a + c b + d Grand total
36
DR MUHAMMAD TAUSEEF JAVED SIMS
37. Sensitivity and Specificity
• Sensitivity and specificity has reciprocal
relationship with each other
• If we increase the sensitivity of a test
specificity will be decreased
37
DR MUHAMMAD TAUSEEF JAVED SIMS
38. Sensitivity and specificity
At cut-off 120 mg all above those will be declared as disease
Which are included as disease by the test
Which are normal but declared as disease (b/ False Positive)
Which are disease but excluded by the test (d/ False Negative)
Comment on Sensitivity and specificity
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39. Conclusion at cut-off value 120 mg / 100 ml
• Nearly 99% of those having diabetes will be picked up by the
test that means test become highly sensitive
• The test is falsely including a large number of normal persons
as the diseased increasing the false positive
• The increasing false positive means that the ability of the test to
exclude those not having the disease is decreasing (decrease in
specificity)
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DR MUHAMMAD TAUSEEF JAVED SIMS
41. Conclusion at cut-off value 160 mg / 100 ml
• Nearly99% of those not having the diabetes will be
excluded by the test mean test become highly specific
(increasing specificity)
• The test will include many of the diseased persons as the
normal increasing the false negative cases
• Increasing number of false negative mean the ability of test
to pick up the diseased people is decreasing (decreasing the
sensitivity)
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DR MUHAMMAD TAUSEEF JAVED SIMS
43. Conclusion at cut-off value 140 mg/100
ml
• The ability of the test to include or exclude the diseased
person is nearly equal or critical (Balance sensitivity and
specificity)
• The number of false positive and false negative are also in
balance
• Therefore the point B is the suitable cut-off value for diabetic
screening with sensitivity and specificity nearly above 90%
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DR MUHAMMAD TAUSEEF JAVED SIMS
44. Reliability of the Screening tests
What are the factors that determine the
reliability of screening tests?
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DR MUHAMMAD TAUSEEF JAVED SIMS
45. Three type of factors effect the
reliability of test
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DR MUHAMMAD TAUSEEF JAVED SIMS
46. Observational Variation
• Intra-observer Variations (variation in
observation when a single observer repeat
the same observation)
• Inter-observer Variation (Different observers
when the same observation is repeated by
different observers
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47. •Use of Multiple Screening Tests
Sequential (Two-stage) Testing
Simultaneous Testing
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51. Prevalence & Predictive Value
Note: Test has 95%
sensitivity and 95%
specificity
51
DR MUHAMMAD TAUSEEF JAVED SIMS
52. Specificity &
Predictive Value
As specificity increases,
positive predictive value
increases.
As sensitivity increases, positive
predictive value also increases, but
to a much lesser extent.
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DR MUHAMMAD TAUSEEF JAVED SIMS
55. Study designs for screening
1. Correlation Studies
Use:
Description of population
Strength:
Suggest possibility of benefit
Limitation:
Can’t test hypothesis 55
DR MUHAMMAD TAUSEEF JAVED SIMS
56. Study designs for screening
2. Analytical Studies
Types:
Case-control
Cohorts
Use:
Comparison
of rates
Advantage:
Test
hypothesis
Limitation:
Selection
Lead time
56
DR MUHAMMAD TAUSEEF JAVED SIMS
57. Study designs for screening
3. Randomized Trials
Use:
Comparison of rates
Strength:
Most valid test of hypothesis
Limitation:
Cost, ethics & feasibility 57
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58. Review Questions (Developed by the
Supercourse team)
• What is screening and what types of screening can you name?
• What are the objectives of screening?
• For what type of diseases would it be appropriate to set up
screening programs? List characteristics.
• How is screening program evaluated?
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DR MUHAMMAD TAUSEEF JAVED SIMS