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factors related to social determinants of health. In such cases, it is done as a preventive measure in order to mitigate any detrimental effects of prolonged exposure to certain risk factors, or to simply begin remedying the adverse effects already faced by certain individuals. They can be structured in different ways, for example, online or in person, and yield different outcomes based on the patient's responses. Some programs, like the FIND Desk at UCSF Benioff
Children's Hospital, employ screening for social determinants of health in order to connect their patients with social services and community resources that may provide patients greater autonomy and mobility.
750:
However, disease-specific mortality might be biased in favor of screening. In the example of breast cancer screening, women overdiagnosed with breast cancer might receive radiotherapy, which increases mortality due to lung cancer and heart disease. The problem is those deaths are often classified as other causes and might even be larger than the number of breast cancer deaths avoided by screening. So the non-biased outcome is all-cause mortality. The problem is that much larger trials are needed to detect a significant reduction in all-cause mortality. In 2016, researcher Vinay Prasad and colleagues published an article in
712:
more likely to come and get screened than those on low-income, who have existing health and social problems. One example of selection bias occurred in
Edinbourg trial of mammography screening, which used cluster randomisation. The trial found reduced cardiovascular mortality in those who were screened for breast cancer. That happened because baseline differences regarding socio-economic status in the groups: 26% of the women in the control group and 53% in the study group belonged to the highest socioeconomic level. Cardiovascular risk screening is a vital tool in reducing the global incidence of cardiovascular diseases.
605:
vanilmandelic acid in urine samples of six-month-old infants. In 2003, a special committee was organized to evaluate the motivation for the neuroblastoma screening program. In the same year, the committee concluded that there was sufficient evidence that screening method used in the time led to overdiagnosis, but there was no enough evidence that the program reduced neuroblastoma deaths. As such, the committee recommended against screening and the
Ministry of Health, Labor and Welfare decided to stop the screening program.
601:". So it might lead to an endless cycle: the greater the overdiagnosis, the more people will think screening is more effective than it is, which can reinforce people to do more screening tests, leading to even more overdiagnosis. Raffle, Mackie and Gray call this the popularity paradox of screening: "The greater the harm through overdiagnosis and overtreatment from screening, the more people there are who believe they owe their health, or even their life, to the programme"(p56 Box 3.4)
455:. Those conditions may have adverse effects on their health and well-being. To mitigate those adverse effects, certain health policies like the United States Affordable Care Act (2010) gave increased traction to preventive programs, such as those that routinely screen for social determinants of health. Screening is believed to a valuable tool in identifying patients' basic needs in a social determinants of health framework so that they can be better served.
675:
632:
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likely to be detected by screening. So, the cases screening often detects automatically have better prognosis than symptomatic cases. The consequence is those more slow progressive cases are now classified as cancers, which increases the incidence, and due to its better prognosis, the survival rates of screened people will be better than non-screened people even if screening makes no difference.
439:
parental notification. There are currently bills being introduced in various U.S. states to mandate mental health screenings for students attending public schools in hopes to prevent self-harm as well as the harming of peers. Those proposing these bills hope to diagnose and treat mental illnesses such as depression and anxiety.
736:
to assess the true value of a screening program. For rare diseases, hundreds of thousands of patients may be needed to realize the value of screening (find enough treatable disease), and to assess the effect of the screening program on mortality a study may have to follow the cohort for decades. Such
707:
Selection bias may also make a test look better than it really is. If a test is more available to young and healthy people (for instance if people have to travel a long distance to get checked) then fewer people in the screening population will have negative outcomes than for a random sample, and the
438:
is sometimes carried out, but is controversial as scoliosis (unlike vision or dental issues) is found in only a very small segment of the general population and because students must remove their shirts for screening. Many states no longer mandate scoliosis screenings, or allow them to be waived with
711:
Studies have shown that people who attend screening tend to be healthier than those who do not. This has been called the healthy screenee effect, which is a form of selection bias. The reason seems to be that people who are healthy, affluent, physically fit, non-smokers with long-lived parents are
608:
Another example of overdiagnosis happened with thyroid cancer: its incidence tripled in United States between 1975 and 2009, while mortality was constant. In South Korea, the situation was even worse with 15-fold increase in the incidence from 1993 to 2011 (the world's greatest increase of thyroid
559:
To many people, screening instinctively seems like an appropriate thing to do, because catching something earlier seems better. However, no screening test is perfect. There will always be the problems with incorrect results and other issues listed above. It is an ethical requirement for balanced
481:
Medical equipment used in screening tests is usually different from equipment used in diagnostic tests as screening tests are used to indicate the likely presence or absence of a disease or condition in people not presenting symptoms; while diagnostic medical equipment is used to make quantitative
472:
Social determinants of health include social status, gender, ethnicity, economic status, education level, access to services, education, immigrant status, upbringing, and much, much more. Several clinics across the United States have employed a system in which they screen patients for certain risk
490:
Screening can detect medical conditions at an early stage before symptoms present while treatment is more effective than for later detection. In the best of cases lives are saved. Like any medical test, the tests used in screening are not perfect. The test result may incorrectly show positive for
463:
When established in the United States, the
Affordable Care Act was able to bridge the gap between community-based health and healthcare as a medical treatment, leading to programs that screened for social determinants of health. The Affordable Care Act established several services with an eye for
749:
The main outcome of cancer screening studies is usually the number of deaths caused by the disease being screened for - this is called disease-specific mortality. To give an example: in trials of mammography screening for breast cancer, the main outcome reported is often breast cancer mortality.
682:
Many screening tests involve the detection of cancers. Screening is more likely to detect slower-growing tumors (due to longer pre-clinical sojourn time) that are less likely to cause harm. Also, those aggressive cancers tend to produce symptoms in the gap between scheduled screening, being less
604:
The screening for neuroblastoma, the most common malignant solid tumor in children, in Japan is a very good example of why a screening program must be evaluated rigorously before it is implemented. In 1981, Japan started a program of screening for neuroblastoma by measuring homovanillic acid and
60:
are designed to identify conditions which could at some future point turn into disease, thus enabling earlier intervention and management in the hope to reduce mortality and suffering from a disease. Although screening may lead to an earlier diagnosis, not all screening tests have been shown to
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actually means in this context, we might attribute success to a screening test that does nothing but advance diagnosis. As survival statistics suffers from this and other biases, comparing the disease mortality (or even all-cause mortality) between screened and unscreened population gives more
612:
The problem of overdiagnosis in cancer screening is that at the time of diagnosis it not possible to differentiate between a harmless lesion and lethal one, unless the patient is not treated and dies from other causes. So almost all patients tend to be treated, leading to what is called
1881:
Ahn, Hyeong Sik; Kim, Hyun Jung; Kim, Kyoung Hoon; Lee, Young Sung; Han, Seung Jin; Kim, Yuri; Ko, Min Ji; Brito, Juan P. (November 2016). "Thyroid Cancer
Screening in South Korea Increases Detection of Papillary Cancers with No Impact on Other Subtypes or Thyroid Cancer Mortality".
639:
If screening works, it must diagnose the target disease earlier than it would be without screening (when symptoms appear). Even if in both cases (with screening vs without screening) patients die at the same time, just because the disease was diagnosed earlier by screening, the
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is controversial because it could cause undue anxiety in patients and support services would be stretched. A GP reported "The main issue really seems to be centred around what the consequences of a such a diagnosis is and what is actually available to help patients."
96:
involves screening a smaller group of people based on the presence of risk factors (for example, because a family member has been diagnosed with a hereditary disease). Screening interventions are not designed to be diagnostic, and often have significant rates of both
1155:
Anne
Andermann, Ingeborg Blancquaert, Sylvie Beauchamp, VĂ©ronique DĂ©ry Revisiting Wilson and Jungner in the genomic age: a review of screening criteria over the past 40 years: Bulletin of the World Health Organization; 2008 Volume 86, Number 4, April 2008,
568:.When studying a screening program using case-control or, more usually, cohort studies, various factors can cause the screening test to appear more successful than it really is. A number of different biases, inherent in the study method, will skew results.
1301:
Shekarchi, Amy, et al. "Social
Determinant of Health Screening in a Safety Net Pediatric Primary Care Clinic." American Academy of Pediatrics, American Academy of Pediatrics, 1 May 2018, pediatrics.aappublications.org/content/142/1_MeetingAbstract/748.
482:
physiological measurements to confirm and determine the progress of a suspected disease or condition. Medical screening equipment must be capable of fast processing of many cases, but may not need to be as precise as diagnostic equipment.
464:
social determinants or an openness to more diverse clientele, such as
Community Transformation Grants, which were delegated to the community in order to establish "preventive community health activities" and "address health disparities".
563:
Before a screening program is implemented, it should be looked at to ensure that putting it in place would do more good than harm. The best studies for assessing whether a screening test will increase a population's health are rigorous
1796:
Esserman, Laura J; Thompson, Ian M; Reid, Brian; Nelson, Peter; Ransohoff, David F; Welch, H Gilbert; Hwang, Shelley; Berry, Donald A; Kinzler, Kenneth W; Black, William C; Bissell, Mina; Parnes, Howard; Srivastava, Sudhir (May 2014).
257:
In many countries there are population-based screening programmes. In some countries, such as the UK, policy is made nationally and programmes are delivered nationwide to uniform quality standards. Common screening programmes include:
2170:
205:
In summation, "when it comes to the allocation of scarce resources, economic considerations must be considered alongside 'notions of justice, equity, personal freedom, political feasibility, and the constraints of current law'."
1483:
Billioux, Alexander; Verlander, Katherine; Anthony, Susan; Alley, Dawn (2017-05-30). "Standardized
Screening for Health-Related Social Needs in Clinical Settings: The Accountable Health Communities Screening Tool".
593:
Aside from issues with unnecessary treatment (prostate cancer treatment is by no means without risk), overdiagnosis makes a study look good at picking up abnormalities, even though they are sometimes harmless.
617:. As researchers Welch and Black put it, "Overdiagnosis—along with the subsequent unneeded treatment with its attendant risks—is arguably the most important harm associated with early cancer detection."
586:; it has been said that "more men die with prostate cancer than of it". Autopsy studies have shown that between 14 and 77% of elderly men who have died of other causes are found to have had
655:. So statistics of survival time since diagnosis tends to increase with screening because of the lead time introduced, even when screening offers no benefits. If we do not think about what
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can be of some value and are typically easier to conduct. Any study must be sufficiently large (include many patients) and sufficiently long (follow patients for many years) to have the
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has not been prolonged. As the diagnosis was made earlier without life being prolonged, the patient might be more anxious as he must live with knowledge of his diagnosis for longer.
434:
Most public school systems in the United States screen students periodically for hearing and vision deficiencies and dental problems. Screening for spinal and posture issues such as
1316:
Gottlieb, Laura; Hessler, Danielle; Long, Dayna; Amaya, Anais; Adler, Nancy (December 2014). "A Randomized Trial on
Screening for Social Determinants of Health: the iScreen Study".
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and accurate information to be given to participants at the point when screening is offered, in order that they can make a fully informed choice about whether or not to accept.
700:
If people with a higher risk of a disease are more likely to be screened, for instance women with a family history of breast cancer are more likely than other women to join a
236:
Multiphasic screening: The application of two or more screening tests to a large population at one time, instead of carrying out separate screening tests for single diseases.
597:
Overdiagnosis occurs when all of these people with harmless abnormalities are counted as "lives saved" by the screening, rather than as "healthy people needlessly harmed by
73:
of screening. Additionally, some screening tests can be inappropriately overused. For these reasons, a test used in a screening program, especially for a disease with low
1688:
Brodersen, John; Kramer, Barnett S; Macdonald, Helen; Schwartz, Lisa M; Woloshin, Steven (17 August 2018). "Focusing on overdiagnosis as a driver of too much medicine".
934:... 8. a. Medical examination of a person or group to detect disease or abnormality, esp. as part of a broad survey rather than as a response to a request for treatment.
1280:
Braveman, P. and Gottlieb, L., 2014. The social determinants of health: it's time to consider the causes of the causes. Public health reports, 129(1_suppl2), pp.19-31.
895:., 1. a preliminary procedure, such as a test or examination, to detect the most characteristic sign or signs of a disorder that may require further investigation.
1292:
Heiman, Harry J., and Samantha Artiga. "Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity." Health 20.10 (2015): 1-10.
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program, then a screening test will look worse than it really is: negative outcomes among the screened population will be higher than for a random sample.
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Screening tests are given to people who seem healthy to try to find unnoticed problems. They're done before you have any signs or symptoms of the disease.
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cancer incidence), while the mortality remained stable. The increase in incidence was associated with the introduction of ultrasonography screening.
334:
1117:
946:
O'Sullivan, Jack W; Albasri, Ali; Nicholson, Brian D; Perera, Rafael; Aronson, Jeffrey K; Roberts, Nia; Heneghan, Carl (11 February 2018).
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studies take a long time and are expensive, but can provide the most useful data with which to evaluate the screening program and practice
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Not everyone will partake in a screening program. There are factors that differ between those willing to get tested and those who are not.
109:
1846:
Ahn, Hyeong Sik; Kim, Hyun Jung; Welch, H. Gilbert (6 November 2014). "Korea's Thyroid-Cancer "Epidemic" — Screening and Overdiagnosis".
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titled "Why cancer screening has never been shown to save lives", as cancer screening trials did not show all-cause mortality reduction.
226:
Mass screening: The screening of a whole population or subgroup. It is offered to all, irrespective of the risk status of the individual.
842:
167:
In 2008, with the emergence of new genomic technologies, the WHO synthesised and modified these with the new understanding as follows:
1424:
Singh, Gopal; Daus, Gem; Allender, Michelle; Ramey, Christine; Martin, Elijah; Perry, Chrisp; Reyes, Andrew; Vedamuthu, Ivy (2017).
1154:
995:
O'Sullivan, Jack W.; Heneghan, Carl; Perera, Rafael; Oke, Jason; Aronson, Jeffrey K.; Shine, Brian; Goldacre, Ben (19 March 2018).
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Stress and anxiety caused by prolonging knowledge of an illness without any improvement in outcome. This problem is referred to as
412:
2171:
UK National Screening Committee Criteria for appraising the viability, appropriateness and effectiveness of a screening programme
1678:
Sandhu GS, Adriole GL. Overdiagnosis of prostate cancer. Journal of the National Cancer Institute Monographs 2012 (45): 146–151.
1226:"Does SARI Score Predict COVID-19 Positivity? A Retrospective Analysis of Emergency Department Patients in a Tertiary Hospital"
2122:
876:
1368:
HHS action plan to reduce racial and ethnic health disparities : a nation free of disparities in health and health care
1604:
423:
2132:
1625:
1389:
Dasgupta, Rajib (2009). Cook, Harold J.; Bhattacharya, Sanjoy; Hardy, Anne (eds.). "Making Sense of Social Determinants".
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1426:"Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016"
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17:
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Length time bias leads to better perceived survival with screening, even if the course of the disease is not altered.
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Screening may identify abnormalities that would never cause a problem in a person's lifetime. An example of this is
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Adverse effects of screening procedure (e.g. stress and anxiety, discomfort, radiation exposure, chemical exposure).
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30:
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Lead time bias leads to longer perceived survival with screening, even if the course of the disease is not altered
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1141:
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The total cost of finding a case should be economically balanced in relation to medical expenditure as a whole.
35:
838:
448:
2195:
2210:
503:
Screening can involve cost and use of medical resources on a majority of people who do not need treatment.
92:
involves screening of all individuals in a certain category (for example, all children of a certain age).
1745:
Raffle AE, Mackie A, Gray JAM. Screening: Evidence and Practice.2nd edition Oxford University Press. 2019
769:
721:
565:
192:
The programme should ensure informed consent, confidentiality and respect for personal, bodily autonomy.
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Health Knowledge Interactive Learning Module on Screening by Angela Raffle. Last accessed October 2019.
809:
729:
108:
Frequently updated recommendations for screening are provided by the independent panel of experts, the
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391:
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308:
121:
70:
74:
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AlGhalyini, Baraa; Shakir, Ismail; Wahed, Muaz; Babar, Sultan; Mohamed, Mohamed (30 June 2022).
997:"Variation in diagnostic test requests and outcomes: a preliminary metric for OpenPathology.net"
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214:
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The programme should integrate education, testing, clinical services and programme management.
1135:
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A false sense of security caused by false negatives, which may delay final diagnosis (namely
271:
195:
The programme should promote equity and access to screening for the entire target population.
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189:
There should be quality assurance, with mechanisms to minimize potential risks of screening.
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382:
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is longer in screened people than in persons who was not screened. This happens even when
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are the economic and social conditions that influence individual and group differences in
8:
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399:
329:
82:
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Why cancer screening has never been shown to "save lives"--and what we can do about it.
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2013:
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1994:
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1341:
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977:
948:"Overtesting and undertesting in primary care: a systematic review and meta-analysis"
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Case-finding should be a continuous process, not just a "once and for all" project.
1626:"GPs hit by widespread complaints from patients 'unhappy' over dementia screening"
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1799:"Addressing overdiagnosis and overtreatment in cancer: a prescription for change"
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387:
359:
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1963:"What is overdiagnosis and why should we take it seriously in cancer screening?"
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45:, in medicine, is a strategy used to look for as-yet-unrecognised conditions or
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102:
98:
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High risk or selective screening: High risk screening is conducted only among
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66:
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Unnecessary investigation and treatment of false positive results (namely
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Commentary: Screening: A seductive paradigm that has generally failed us.
1979:
1962:
1859:
831:"To Screen or Not to Screen? - The Benefits and Harms of Screening Tests"
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289:
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There should be scientific evidence of screening programme effectiveness.
170:
Synthesis of emerging screening criteria proposed over the past 40 years
46:
2063:"Screening Strategies for Cardiovascular Disease in Asymptomatic Adults"
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908:
50:
1989:
1710:
1701:
1442:
715:
1603:. Institute for Quality and Efficiency in Health Care (IQWiG). 2006.
1521:"Enhancing Pediatric Mental Health Care: Algorithms for Primary Care"
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871:(9th ed.). St. Louis, Mo.: Elsevier/Mosby. Kindle loc. 145535.
744:
2061:
Wallace, Margaret L.; Ricco, Jason A.; Barrett, Bruce (June 2014).
804:
674:
403:
365:
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The natural history of the disease should be adequately understood.
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1687:
1169:"When can a risk factor be used as a worthwhile screening test?"
239:
When done thoughtfully and based on research, identification of
994:
452:
442:
1482:
177:
The objectives of screening should be defined at the outset.
174:
The screening programme should respond to a recognized need.
69:, and creating a false sense of security are some potential
27:
Brief medical evaluation to detect unnoticed health problems
1430:
International Journal of Maternal and Child Health and AIDS
407:
201:
The overall benefits of screening should outweigh the harm.
142:
Facilities for diagnosis and treatment should be available.
49:. This testing can be applied to individuals or to a whole
1795:
1223:
458:
53:
without symptoms or signs of the disease being screened.
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There should be a test or examination for the condition.
1741:
1739:
1737:
274:
to detect potentially precancerous lesions and prevent
198:
Programme evaluation should be planned from the outset.
1423:
218:
A mobile clinic used to screen coal miners at risk of
1755:
Tsubono, Yoshitaka; Hisamichi, Shigeru (6 May 2004).
132:. The principles are still broadly applicable today:
1734:
720:
The best way to minimize selection bias is to use a
499:). Limitations of screening programmes can include:
136:
The condition should be an important health problem.
2060:
2005:
716:
Study Design for the Research of Screening Programs
1672:
1095:"Principles and practice of screening for disease"
907:
495:), or negative for people who have the condition (
157:There should be an agreed policy on whom to treat.
2011:
1915:
1913:
1166:
745:All-cause mortality vs disease-specific mortality
2202:
1754:
1160:
424:Screening for potential hearing loss in newborns
362:for pregnant women to detect fetal abnormalities
151:The test should be acceptable to the population.
126:Principles and practice of screening for disease
2014:"Screening for breast cancer with mammography"
1910:
708:test will seem to make a positive difference.
145:There should be a latent stage of the disease.
139:There should be a treatment for the condition.
34:A coal miner completes a screening survey for
1960:
1926:JNCI Journal of the National Cancer Institute
1681:
1167:Wald, N J; Hackshaw, A K; Frost, C D (1999).
1092:
1880:
1789:
1757:"A Halt to Neuroblastoma Screening in Japan"
180:There should be a defined target population.
110:United States Preventive Services Task Force
1845:
866:
443:Screening for social determinants of health
1961:Carter, Stacy; Barratt, Alexandra (2017).
1954:
1919:
1658:. Men's Health Books. Rodale Books. 2000.
1569:"UCSF Benioff Children's Hospital Oakland"
2094:
2037:
2012:Gøtzsche, P.C.; Jørgensen, K. J. (2013).
1988:
1978:
1937:
1822:
1772:
1709:
1597:"Benefits and risks of screening tests".
1536:
1459:
1441:
1200:
1028:
971:
476:
1573:UCSF Benioff Children's Hospital Oakland
1388:
673:
651:If screening works, it must introduce a
630:
413:Screening of potential sperm bank donors
368:radiographs to screen for interproximal
243:can be a strategy for medical screening.
213:
29:
2018:Cochrane Database of Systematic Reviews
1839:
14:
2203:
1217:
459:Policy background in the United States
2123:International Journal of Epidemiology
1967:Public Health Research & Practice
1311:
1309:
1307:
1288:
1286:
1233:Journal of Health and Allied Sciences
1086:
845:from the original on 22 December 2017
1068:
467:
128:, which is often referred to as the
2147:Prasad V., Lenzer J., Newman D.H.,
1920:Welch, H. G.; Black, W. C. (2010).
1518:
663:
61:benefit the person being screened;
24:
2164:
1632:. 22 November 2013. Archived from
1304:
1283:
1072:(2019). "Too Many Medical Tests".
252:
88:Several types of screening exist:
25:
2232:
1656:The Complete Book of Men's Health
924:from the original on 11 June 2017
686:
620:
2182:Screening: evidence and practice
1262:from the original on 4 July 2022
1093:Wilson, JMG; Jungner, G (1968).
571:
2141:
2111:
2054:
1874:
1848:New England Journal of Medicine
1761:New England Journal of Medicine
1748:
1648:
1618:
1607:from the original on 2021-01-20
1590:
1579:from the original on 2013-07-28
1561:
1519:Foy, Jane Meschan (June 2010).
1512:
1476:
1417:
1382:
1360:
1295:
1274:
1123:from the original on 2016-04-17
867:O'Toole, Marie T., ed. (2013).
800:UK National Screening Committee
516:Stress and anxiety caused by a
429:
302:Dermatological check to detect
2184:. Oxford University Press 2019
2030:10.1002/14651858.CD001877.pub5
1148:
1062:
1053:Screening and Diagnostic Tests
1045:
988:
939:
900:
860:
823:
546:Screening for dementia in the
485:
339:Liebowitz Social Anxiety Scale
13:
1:
1815:10.1016/S1470-2045(13)70598-9
1391:Economic and Political Weekly
839:National Institutes of Health
816:
642:survival time since diagnosis
449:social determinants of health
115:
566:randomized controlled trials
124:published guidelines on the
7:
1774:10.1056/NEJM200405063501922
1531:(Supplement 3): S109–S125.
964:10.1136/bmjopen-2017-018557
770:General medical examination
757:
722:randomized controlled trial
554:
247:
130:Wilson and Jungner criteria
36:coalworker's pneumoconiosis
10:
2237:
1140:: CS1 maint: postscript (
1130:Public Health Papers, #34.
1021:10.1038/s41598-018-23263-z
869:Mosby's medical dictionary
810:Incidental imaging finding
690:
667:
624:
575:
319:to screen for exposure to
81:in addition to acceptable
2079:10.1016/j.pop.2014.02.010
1922:"Overdiagnosis in Cancer"
1185:10.1136/bmj.319.7224.1562
918:Oxford English Dictionary
795:Category:Cancer screening
584:prostate cancer screening
392:abdominal aortic aneurysm
326:Beck Depression Inventory
311:to detect prostate cancer
122:World Health Organization
660:meaningful information.
209:
2152:British Medical Journal
1538:10.1542/peds.2010-0788f
739:evidence-based medicine
491:those without disease (
347:social anxiety disorder
343:Social Phobia Inventory
2175:Oxford Medicine Online
1330:10.1542/peds.2014-1439
1245:10.1055/s-0042-1748806
679:
636:
477:Medical equipment used
381:and image grading for
222:
39:
2180:Raffle, Mackie, Gray
1896:10.1089/thy.2016.0075
730:retrospective studies
691:Further information:
677:
668:Further information:
634:
625:Further information:
576:Further information:
272:liquid-based cytology
217:
33:
1980:10.17061/phrp2731722
1860:10.1056/NEJMp1409841
383:diabetic retinopathy
2211:Medical terminology
1939:10.1093/jnci/djq099
1803:The Lancet Oncology
1636:on 18 February 2017
1179:(7224): 1562–1565.
1013:2018NatSR...8.4752O
728:, naturalistic, or
379:digital photography
90:universal screening
2135:2019-01-29 at the
2125:, 244(1): 278-280
1600:InformedHealth.org
1324:(6): e1611–e1618.
1075:Skeptical Inquirer
1001:Scientific Reports
835:NIH News in Health
680:
637:
419:metabolic syndrome
294:fecal occult blood
223:
220:black lung disease
40:
18:Medical screenings
1890:(11): 1535–1540.
1854:(19): 1765–1767.
1767:(19): 2010–2011.
1702:10.1136/bmj.k3494
1443:10.21106/ijma.236
878:978-0-323-08541-0
785:Newborn screening
734:statistical power
520:screening result.
513:(see also below).
468:Clinical programs
352:Alpha-fetoprotein
298:colorectal cancer
77:, must have good
16:(Redirected from
2228:
2158:
2154:2016; 352:h6080
2145:
2139:
2117:Gøtzsche, P.C.,
2115:
2109:
2108:
2098:
2058:
2052:
2051:
2041:
2009:
2003:
2002:
1992:
1982:
1958:
1952:
1951:
1941:
1917:
1908:
1907:
1878:
1872:
1871:
1843:
1837:
1836:
1826:
1809:(6): e234–e242.
1793:
1787:
1786:
1776:
1752:
1746:
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1732:
1731:
1713:
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1679:
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1669:
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1559:
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1540:
1516:
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1509:
1498:10.31478/201705b
1486:NAM Perspectives
1480:
1474:
1473:
1463:
1445:
1421:
1415:
1414:
1386:
1380:
1379:
1364:
1358:
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1272:
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1269:
1267:
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1215:
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1164:
1158:
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1146:
1145:
1139:
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1129:
1128:
1122:
1099:
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1084:
1083:
1066:
1060:
1049:
1043:
1042:
1032:
992:
986:
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975:
943:
937:
936:
931:
929:
915:
904:
898:
897:
864:
858:
857:
852:
850:
827:
670:Length time bias
664:Length time bias
360:ultrasound scans
263:Cancer screening
231:high-risk people
21:
2236:
2235:
2231:
2230:
2229:
2227:
2226:
2225:
2201:
2200:
2167:
2165:Further reading
2162:
2161:
2146:
2142:
2137:Wayback Machine
2116:
2112:
2059:
2055:
2024:(6): CD001877.
2010:
2006:
1959:
1955:
1918:
1911:
1879:
1875:
1844:
1840:
1794:
1790:
1753:
1749:
1744:
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1673:
1666:
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1624:
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1477:
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1296:
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1222:
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1161:
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1126:
1124:
1120:
1108:(11): 281–393.
1097:
1091:
1087:
1067:
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1050:
1046:
993:
989:
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940:
927:
925:
906:
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901:
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865:
861:
848:
846:
829:
828:
824:
819:
814:
775:Genetic testing
765:Fetal screening
760:
747:
718:
695:
689:
672:
666:
629:
623:
588:prostate cancer
580:
574:
557:
488:
479:
470:
461:
445:
432:
388:Ultrasound scan
296:test to detect
276:cervical cancer
255:
253:Common programs
250:
212:
118:
71:adverse effects
28:
23:
22:
15:
12:
11:
5:
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2218:
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2110:
2073:(2): 371–397.
2053:
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1953:
1932:(9): 605–613.
1909:
1873:
1838:
1788:
1747:
1733:
1680:
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1664:
1647:
1617:
1589:
1560:
1511:
1475:
1436:(2): 139–164.
1416:
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1273:
1216:
1159:
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1085:
1061:
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987:
958:(2): e018557.
938:
920:. March 2017.
899:
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841:. March 2017.
821:
820:
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813:
812:
807:
802:
797:
792:
787:
782:
777:
772:
767:
761:
759:
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746:
743:
717:
714:
693:Selection bias
688:
687:Selection bias
685:
665:
662:
627:Lead time bias
622:
621:Lead time bias
619:
573:
570:
556:
553:
544:
543:
532:
521:
518:false positive
514:
507:
504:
497:false negative
493:false positive
487:
484:
478:
475:
469:
466:
460:
457:
444:
441:
431:
428:
427:
426:
421:
417:Screening for
415:
410:
400:Screening Tool
394:
385:
375:Ophthalmoscopy
372:
363:
349:
345:to screen for
332:
328:to screen for
323:
314:
313:
312:
306:
300:
287:
278:
254:
251:
249:
246:
245:
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237:
234:
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103:false negative
99:false positive
26:
9:
6:
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2233:
2222:
2219:
2217:
2216:Medical tests
2214:
2212:
2209:
2208:
2206:
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2194:
2192:
2191:9780198805984
2188:
2185:
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2072:
2068:
2064:
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2045:
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2035:
2031:
2027:
2023:
2019:
2015:
2008:
2000:
1996:
1991:
1986:
1981:
1976:
1972:
1968:
1964:
1957:
1949:
1945:
1940:
1935:
1931:
1927:
1923:
1916:
1914:
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1897:
1893:
1889:
1885:
1877:
1869:
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1842:
1834:
1830:
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1800:
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1770:
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1665:9781579542986
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1397:(23): 30–32.
1396:
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1339:
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1115:
1111:
1107:
1103:
1102:WHO Chronicle
1096:
1089:
1081:
1077:
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1071:
1070:Hall, Harriet
1065:
1059:
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727:
726:observational
723:
713:
709:
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703:
698:
694:
684:
676:
671:
661:
658:
657:survival time
654:
649:
647:
643:
633:
628:
618:
616:
615:overtreatment
610:
606:
602:
600:
599:overdiagnosis
595:
591:
589:
585:
579:
578:Overdiagnosis
572:Overdiagnosis
569:
567:
561:
552:
549:
541:
540:Type II error
537:
533:
530:
526:
522:
519:
515:
512:
511:overdiagnosis
508:
505:
502:
501:
500:
498:
494:
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474:
465:
456:
454:
453:health status
450:
440:
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411:
409:
405:
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398:
395:
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380:
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371:
370:dental caries
367:
364:
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340:
336:
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324:
322:
318:
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310:
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301:
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295:
291:
288:
286:
285:breast cancer
282:
279:
277:
273:
269:
266:
265:
264:
261:
260:
259:
242:
238:
235:
232:
228:
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216:
207:
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173:
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159:
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150:
147:
144:
141:
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135:
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133:
131:
127:
123:
120:In 1968, the
113:
111:
106:
104:
100:
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91:
86:
84:
80:
76:
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68:
64:
63:overdiagnosis
59:
58:interventions
54:
52:
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44:
37:
32:
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2181:
2148:
2143:
2118:
2113:
2070:
2067:Primary care
2066:
2056:
2021:
2017:
2007:
1970:
1966:
1956:
1929:
1925:
1887:
1883:
1876:
1851:
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1802:
1791:
1764:
1760:
1750:
1693:
1689:
1683:
1674:
1655:
1650:
1638:. Retrieved
1634:the original
1629:
1620:
1609:. Retrieved
1599:
1592:
1581:. Retrieved
1572:
1563:
1528:
1524:
1514:
1489:
1485:
1478:
1433:
1429:
1419:
1394:
1390:
1384:
1367:
1362:
1321:
1317:
1297:
1276:
1264:. Retrieved
1236:
1232:
1219:
1176:
1172:
1162:
1150:
1136:cite journal
1125:. Retrieved
1105:
1101:
1088:
1079:
1073:
1064:
1051:
1047:
1004:
1000:
990:
955:
951:
941:
933:
926:. Retrieved
917:
910:
909:"screening,
902:
892:
890:
868:
862:
854:
847:. Retrieved
834:
825:
780:Medical test
751:
748:
719:
710:
706:
699:
696:
681:
656:
652:
650:
645:
641:
638:
611:
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596:
592:
581:
562:
558:
545:
536:misdiagnosis
529:Type I error
525:misdiagnosis
489:
480:
471:
462:
446:
433:
430:School-based
321:tuberculosis
256:
241:risk factors
204:
169:
166:
129:
125:
119:
107:
94:Case finding
93:
89:
87:
67:misdiagnosis
55:
47:risk markers
42:
41:
1640:22 November
1239:: 077–082.
1082:(3): 25–27.
1007:(1): 4752.
891:screening,
790:Pedodontics
702:mammography
548:English NHS
486:Limitations
356:blood tests
290:Colonoscopy
281:Mammography
83:specificity
79:sensitivity
2221:Prevention
2205:Categories
1990:2123/17022
1711:2292/46091
1611:2020-09-23
1583:2020-04-29
1525:Pediatrics
1318:Pediatrics
1127:2016-01-01
928:12 January
849:12 January
817:References
330:depression
283:to detect
116:Principles
56:Screening
51:population
2087:0095-4543
1696:: k3494.
1547:0031-4005
1506:2578-6865
1452:2161-8674
1403:0012-9976
1376:872276544
1338:0031-4005
1253:250189262
1193:0959-8138
1058:eMedicine
887:788298656
724:, though
653:lead time
646:life span
436:scoliosis
268:Pap smear
105:results.
75:incidence
43:Screening
2133:Archived
2121:, 2015,
2105:24830613
2048:23737396
1999:28765855
1948:20413742
1904:27627550
1868:25372084
1833:24807866
1783:15128908
1728:52033494
1720:30120097
1605:Archived
1577:Archived
1555:20519563
1470:29367890
1411:40279083
1354:18189510
1346:25367545
1257:Archived
1211:10591726
1118:Archived
1039:29556075
982:29440142
952:BMJ Open
922:Archived
843:Archived
805:Theranos
758:See also
555:Analysis
404:COVID-19
366:Bitewing
317:PPD test
304:melanoma
248:Examples
2096:4042912
2039:6464778
1884:Thyroid
1824:4322920
1461:5777389
1202:1117271
1156:241-320
1114:4234760
1030:5859290
1009:Bibcode
973:5829845
2189:
2103:
2093:
2085:
2046:
2036:
1997:
1946:
1902:
1866:
1831:
1821:
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1251:
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980:
970:
885:
875:
337:, the
335:SPAI-B
1973:(3).
1724:S2CID
1630:Pulse
1492:(5).
1407:JSTOR
1350:S2CID
1260:(PDF)
1249:S2CID
1229:(PDF)
1121:(PDF)
1098:(PDF)
538:with
527:with
210:Types
2187:ISBN
2173:and
2101:PMID
2083:ISSN
2044:PMID
2022:2013
1995:PMID
1944:PMID
1900:PMID
1864:PMID
1829:PMID
1779:PMID
1716:PMID
1660:ISBN
1642:2013
1551:PMID
1543:ISSN
1502:ISSN
1466:PMID
1448:ISSN
1399:ISSN
1372:OCLC
1342:PMID
1334:ISSN
1268:2022
1207:PMID
1189:ISSN
1142:link
1110:PMID
1035:PMID
978:PMID
930:2020
883:OCLC
873:ISBN
851:2020
447:The
408:MERS
406:and
402:for
397:SARI
390:for
358:and
341:and
292:and
101:and
2156:DOI
2127:DOI
2091:PMC
2075:doi
2034:PMC
2026:doi
1985:hdl
1975:doi
1934:doi
1930:102
1892:doi
1856:doi
1852:371
1819:PMC
1811:doi
1769:doi
1765:350
1706:hdl
1698:doi
1694:362
1690:BMJ
1533:doi
1529:125
1494:doi
1456:PMC
1438:doi
1326:doi
1322:134
1241:doi
1197:PMC
1181:doi
1177:319
1173:BMJ
1056:at
1025:PMC
1017:doi
968:PMC
960:doi
752:BMJ
377:or
309:PSA
270:or
2207::
2129:,
2099:.
2089:.
2081:.
2071:41
2069:.
2065:.
2042:.
2032:.
2020:.
2016:.
1993:.
1983:.
1971:27
1969:.
1965:.
1942:.
1928:.
1924:.
1912:^
1898:.
1888:26
1886:.
1862:.
1850:.
1827:.
1817:.
1807:15
1805:.
1801:.
1777:.
1763:.
1759:.
1736:^
1722:.
1714:.
1704:.
1692:.
1628:.
1575:.
1571:.
1549:.
1541:.
1527:.
1523:.
1500:.
1488:.
1464:.
1454:.
1446:.
1432:.
1428:.
1405:.
1395:44
1393:.
1370:.
1348:.
1340:.
1332:.
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