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A framework provided an outline toward the proper evaluation of potential screening strategies

Adriaensen, W.J.
Mathei, C.
Buntinx, F.J.
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Abstract

OBJECTIVES: Screening tests are often introduced into clinical practice without proper evaluation, despite the increasing awareness that screening is a double-edged sword that can lead to either net benefits or harms. Our objective was to develop a comprehensive framework for the evaluation of new screening strategies. STUDY DESIGN AND SETTING: Elaborating on the existing concepts proposed by experts, a stepwise framework is proposed to evaluate whether a potential screening test can be introduced as a screening strategy into clinical practice. The principle of screening strategy evaluation is illustrated for cervical cancer, which is a template for screening because of the existence of an easily detectable and treatable precursor lesion. RESULTS: The evaluation procedure consists of six consecutive steps. In steps 1-4, the technical accuracy, place of the test in the screening pathway, diagnostic accuracy, and longitudinal sensitivity and specificity of the screening test are assessed. In steps 5 and 6, the impact of the screening strategy on the patient and population levels, respectively, is evaluated. The framework incorporates a harm and benefit trade-off and cost-effectiveness analysis. CONCLUSION: Our framework provides an outline toward the proper evaluation of potential screening strategies before considering implementation

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2013-02-06
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Peer reviewed scientific article
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accuracy, analysi, analysis, AS, Awareness, Belgium, Benefit, benefits, cancer, care, Cervical, cervical cancer, CERVICAL-CANCER, Clinical, Cost effectiveness, Cost-effectiveness, Design, diagnostic accuracy, electronic, EVALUATION, general, General practice, Harm, health, Impact, implementation, IS, journal, Lead, LEVEL, levels, longitudinal, Objective, objectives, Patient, POPULATION, Practice, precursor, primary care, public, public health, Public-health, result, results, SCREENING, screening test, SENSITIVITY, Sensitivity and Specificity, specificity, Strategies, Strategy, study, study design, Test, tests
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