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Author Dr Has Joshi

22/12/98

Definitions

• the dictionary says "to separate by sifting"

• applied medically it means looking at a defined population for a marker, the alteration of
  which if present will be benefit to the patient.

What are we screening for ?
o is it common enough and important enough to warrant the effort ?
o is there a readily available treatment ?
o is it going to be cost effective ?
o can you detect it early enough to take effective action ?

How to screen ?
o is there a reliable test available ?
o is the test cheap enough to use ?
o is the test acceptable to the patient ?
o is there any risk in the test procedure ?
o have we the staff and facilities to undertake the test ?

Who to screen ?
o consider the age group and sex
o is it better to further restrict the group selected ?
o will they accept the treatment offered if it is needed ?
o can you get at the target population and how ?

When to screen ?
o how often do you propose to repeat the test ?
o consider the recall systems.

Where will you screen ?
o will the test be done at home,work or in surgery ?
o who will perform the test ?

Think?
Does cervical screening satisfies the screening criteria ?

Is routine BP measurement a valid and reliable test for screening for hypertension ?

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