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How Do We Identify Disease Early to Minimize Its Consequences? 

How Do We Identify Disease Early to Minimize Its Consequences?
Chapter:
How Do We Identify Disease Early to Minimize Its Consequences?
Author(s):

Katherine M. Keyes

and Sandro Galea

DOI:
10.1093/med/9780199331246.003.0013
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date: 27 September 2020

This chapter introduces the reader to foundational concepts in disease screening as well as public health approaches to evaluating screening programs. It discusses central measures in screening including sensitivity, specificity, positive predictive value, and negative predictive value. The chapter also shows how these parameters change when cut points for screen tests are changed and the relation between disease prevalence and positive as well as negative predictive values. It also goes into discussion of guidelines for screening programs, including the need for a early detection to prevent symptoms or slow death. In screening program evaluation, there are unique biases that threaten the validity of inference. This chapter provides readers with examples from successful public health screening programs to illustrate the central concepts of screening for public health prevention.

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