Checking a blood type on a woman early in her pregnancy has become standard of care in the US since the 1970s. Then, consider a reasonable ("good") screening test. By eliminating these unnecessary tests, we can pay for thousands or millions of rational screening tests per year. Multiply one CBC or CMP by thousands or millions of patients per year. Moreover, they may rationalize that at least they are not ordering a total body CT scan for screening. The reason (not without some basis in reality) that they are more likely to be criticized (or sued) for doing too little rather than too much, so they err on the side of doing too much. There's no evidence that a routine CBC or CMP in a healthy, asymptomatic adult is useful, reasonable, or cost-effective. The patient in question is a healthy asymptomatic adult, not a hypertensive patient in whom we are following serum chemistry or a patient with menorrhagia in whom we are following a CBC. Is there any scientific support for this? No. Doctors do this to identify some asymptomatic disease (screening for anemia or hypokalemia). Many patients get an annual (or periodic) complete blood count (CBC) and comprehensive metabolic panel (CMP). There is no perfect screening test, but looking at a questionable screening test and a reasonable screening test is helpful for understanding the issues.įirst, consider a questionable (bad) screening test. That the issue even arises highlights the urgent need for better screening tests. However, asking a patient without medical training to understand issues that challenge the intellect and judgment of most trained clinicians does not seem realistic. That may be possible if your patient is an educated professional. Recently, "shared decision making" has been suggested as an option when there is uncertainty about the advisability of a particular screening test (such as the prostate-specific antigen, or PSA, for the early diagnosis of prostate cancer). There are legitimate debates about sensitivity and specificity, disease prevalence, predictive values, lead-time bias, screening intervals, and appropriate cutoffs for positive or negative results. Even a single screening test, applied to a large number (millions) of people, can result in billions of dollars of health care expenditure annually. The economic implications of screening are real. Many articles about screening present a bewildering array of medical economics and biostatistics to make their points and a multitude of credible organizations have offered their own (often differing) screening recommendations. ![]() Unfortunately, health screening is complicated. Healthcare providers can agree that early diagnosis of a life-threatening disease, for which there is an effective treatment, is a positive action. Many screening tests are widely used in the United States. We often think of screening for early diagnosis of cancer (such as Pap smears for cervical cancer or colonoscopy for colon cancer), but there are many other screening tests commonly used, for example, thyroid-stimulating hormone (TSH) for congenital hypothyroidism in newborns, cholesterol level for heart disease, urine drug screen for illicit drug use, or blood pressure for hypertension. Some screening tests are applied to a large segment of the population (for instance, all adults older than age 50), while others target a smaller subset of the population (pregnant women). This activity provides guidelines on the current screening tests and the role of the interprofessional team in patient education on the benefits of screening.Ī health screening test is a medical test or procedure performed on members of an asymptomatic population or population subgroup to assess their likelihood of having a particular disease. ![]() Many screening tests are widely used in the United States. Some screening tests are applied to a large segment of the population (for instance, all adults older than age 50), while others target a smaller subset of the population (pregnant women). Health professionals often think of screening for early diagnosis of cancer (such as Pap smears for cervical cancer or colonoscopy for colon cancer), but there are many other screening tests commonly used, for example, thyroid-stimulating hormone (TSH) for congenital hypothyroidism in newborns, cholesterol level for heart disease, urine drug screen for illicit drug use, or blood pressure for hypertension. A health screening test is a medical test or procedure performed on members of an asymptomatic population or population subgroup to assess their likelihood of having a particular disease.
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