Mass screening

About: Mass screening is a research topic. Over the lifetime, 34508 publications have been published within this topic receiving 1365148 citations.

Multiple high risk HPV infections are common in cervical neoplasia and young women in a cervical screening population.

Abstract: The implementation of cytology based cervical screening programmes has reduced the incidence of cervical carcinoma world wide. Consequently, the development of improved cytological preparation methods such as liquid based cytology (LBC) and thin layer slide preparation has been welcomed. The addition of high risk human papillomavirus (HR-HPV) testing may further enhance the accuracy of screening programmes. Accumulating evidence suggests that detection of persistent infection with the same HR-HPV type would highlight individuals at greater risk of disease progression,1,2 yet the extent and importance of multiple HR-HPV infections in the progression of cervical neoplasia and its management remain unknown. To investigate these issues it is necessary to use genotyping methods that can track the persistence of specific HPV types and detect infections with multiple HR-HPV types. “Accumulating evidence suggests that detection of persistent infection with the same high risk human papillomavirus (HR-HPV) type would highlight individuals at greater risk of disease progression, yet the extent and importance of multiple HR-HPV infections in the progression of cervical neoplasia and its management remain unknown” A recent directive issued by the Scottish Executive has promoted the roll out of cervical LBC for use throughout primary care in Scotland. The residual material from LBC specimens is an ideal template for HPV testing. We have investigated the prevalence and diversity of HPV infection in a routine cervical screening population in Scotland using residual material from LBC specimens. The extent of multiple HPV infections was assessed and compared with cytological assessment of neoplasia. The results constitute the baseline data of a longitudinal study designed to investigate the impact of HPV detection, multiple HPV infection, and HPV type specific persistence on progression of cervical neoplasia.

Validation of the depression anxiety stress scales (DASS) 21 as a screening instrument for depression and anxiety in a rural community-based cohort of northern Vietnamese women

Abstract: Depression and anxiety are recognised increasingly as serious public health problems among women in low- and lower-middle income countries. The aim of this study was to validate the 21-item Depression Anxiety and Stress Scale (DASS21) for use in screening for these common mental disorders among rural women with young children in the North of Vietnam. The DASS-21 was translated from English to Vietnamese, culturally verified, back-translated and administered to women who also completed, separately, a psychiatrist-administered Structured Clinical Interview for DSM IV Axis 1 diagnoses of depressive and anxiety disorders. The sample was a community-based representative cohort of adult women with young children living in Ha Nam Province in northern Viet Nam. Cronbach’s alpha, Exploratory Factor Analyses (EFA) and Receiver Operating Characteristic (ROC) analyses were performed to identify the psychometric properties of the Depression, Anxiety, and Stress subscales and the overall scale. Complete data were available for 221 women. The internal consistency (Cronbach’s alpha) of each sub-scale and the overall scale were high, ranging from 0.70 for the Stress subscale to 0.88 for the overall scale, but EFA indicated that the 21 items all loaded on one factor. Scores on each of the three sub-scales, and the combinations of two or three of them were able to detect the common mental disorders of depression and anxiety in women with a sensitivity of 79.1% and a specificity of 77.0% at the optimal cut off of >33. However, they did not distinguish between those experiencing only depression or only anxiety. The total score of the 21 items of the DASS21-Vietnamese validation appears to be comprehensible and sensitive to detecting common mental disorders in women with young children in primary health care in rural northern Vietnam and therefore might also be useful to screen for these conditions in other resource-constrained settings.

Screening for developmental dysplasia of the hip: a systematic literature review for the US Preventive Services Task Force.

Abstract: BACKGROUND. Developmental dysplasia of the hip (DDH) represents a spectrum of anatomic abnormalities that can result in permanent disability. OBJECTIVE. We sought to gather and synthesize the published evidence regarding screening for DDH by primary care providers. METHODS. We performed a systematic review of the literature by using a best-evidence approach as used by the US Preventive Services Task Force. The review focused on screening relevant to primary care in infants from birth to 6 months of age and on interventions used in infants before 1 year of age. RESULTS. The literature on screening and interventions for DDH suffers from significant methodologic shortcomings. No published trials directly link screening to improved functional outcomes. Clinical examination and ultrasound identify somewhat different groups of newborns who are at risk for DDH. A significant proportion of hip abnormalities identified through clinical examination or ultrasound in the newborn period will spontaneously resolve. Very few studies examine the functional outcomes of patients who have undergone therapy for DDH. Because of the high rate and unpredictable nature of spontaneous resolution of DDH and the absence of rigorous comparative studies, the effectiveness of interventions is not known. All surgical and nonsurgical interventions have been associated with avascular necrosis of the femoral head, the most common and most severe harm associated with all treatments of DDH. CONCLUSIONS. Screening with clinical examination or ultrasound can identify newborns at increased risk for DDH, but because of the high rate of spontaneous resolution of neonatal hip instability and dysplasia and the lack of evidence of the effectiveness of intervention on functional outcomes, the net benefits of screening are not clear.

A Screening Procedure for Oropharyngeal Dysphagia

Abstract: The present study was designed to examine the sensitivity and specificity of a 28-item screening test in identifying patients who aspirate, have an oral stage disorder, a pharyngeal delay, or a pharyngeal stage disorder. The screening test includes 28 items divided into 5 categories: (1) 4 medical history variables; (2) 6 behavioral variables; (3) 2 gross motor variables; (4) 9 observations from oromotor testing; and (5) 7 observations during trial swallows. Results identified variables that were able to classify patients correctly as having or not having aspiration 71% of the time, an oral stage disorder 69% of the time, a pharyngeal delay 72% of the time, and a pharyngeal stage swallowing problem 70% of the time. Sensitivity and specificity for each of these judgments and all 28 items on the test are also provided. Results are discussed relative to statistical, clinical, and third-party perspectives on the goals of screening, data from other screening tests, and the role of screening versus diagnostic testing in care of dysphagic patients.

Simplified models of screening for chronic disease: estimation procedures from mass screening programmes.

Abstract: The performance of a screening programme depends on a number of parameters, which may need different types of information for their estimation. In this paper, two characteristics of interest, the sojourn-time distribution and the sensitivity, are considered, and estimation procedures, based on data which should be available from a mass screening programme, are proposed. The methods are applied to published data from the HIP breast cancer screening project, to which a negative exponential distribution for the sojourn-time distribution fitted better than the other families of distribution considered.