Disease constitutes a significant public health problem, meaning that it is a relatively common condition with significant morbidity and mortality or disease is contagious and might infect others before symptoms occur and disease detected. |
Disease is rare or not serious or, if serious there is no effective treatment for disease. |
The population to be screened can be so defined that the prevalence is high and there are no significant co-morbidities. |
Unknown or low population prevalence |
Treatment before symptoms occur is more effective than if treatment is delayed |
No benefit to early treatment and/or significant likelihood of overdiagnosis (pseudodisease) |
“Gold Standard” diagnostic exists and screening test sensitivity and specificity is high and based on adequate sample size |
Screening test data is based on small sample sizes or is difficult to extrapolate to larger pool of screening centers with high sensitivity and specificity (e.g. high inter-observer variability) |
Consequences of false negative or false positives are modest |
Consequences of one or more of these errors significant |
Screening test is inexpensive, easy to administer, not harmful and reliable |
Any of these circumstances not met |
There must be some mechanism for follow-up of subjects with positive screening results to ensure subsequent diagnostic testing and ultimate treatment takes place. |
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