NR503 Week 2: Screening & Reliability.

From the U.S. Preventive Task Force website https://www.uspreventiveservicestaskforce.org/BrowseRec/Index (Links to an external site.)Links to an external site., choose one screening test that might be considered in pr ...

From the U.S. Preventive Task Force website https://www.uspreventiveservicestaskforce.org/BrowseRec/Index (Links to an external site.)Links to an external site., choose one screening test that might be considered in primary care. Define the test, its positive predictive value, reliability and validity. Discuss patient medical or family history that may alter your recommendation for screening? Dr. Costello and class, While the benefits and harms of mammography screening have been debated heatedly in the past years, it is a helpful diagnostic tool that should be considered in primary care. The main benefit of mammography screening is to check for breast cancer in women with or without signs and symptoms of the disease (Louberg, Lousdal, Bretthauer, & Kalager, 2015). It is an xray picture of the breast to visualize and magnify certain areas to help physicians make an accurate diagnosis. The U.S. Preventive Services Task Force [USPSTF] (2014) recommends biennial screening mammography for women aged 50 to 74 years old. According to Gordis (2014), a positive predictive value determines the probability that the patient has the disease if the test results are positive. To calculate the positive predictive value, the number of true positives is divided by the total number who tested positive. A screening test is deemed reliable if the results obtained is replicated every time the test is repeated, regardless of the sensitivity and specificity of a test (Gordis, 2014). While mammography testing has effectively helped to reduce breast-cancer abnormalities, the reliability is not extremely high. False-positive results and overdiagnosis can occur with mammography screening. A potential abnormality can be seen on the test, but may not necessarily mean cancer is present. Additional testing would then be recommended to determine further diagnosis. On the other hand, validity is defined as the ability of a test to determine who has a disease and who does not (Gordis, 2014). It has two components: sensitivity and specificity. The sensitivity of a test is defined as the ability of a test to correctly identify those with the disease while the specificity of a test is the ability to correctly identify those who do not have the disease. When evaluating screening tests, it is important to understand that a test may not be reliable if results cannot be replicated regardless of how sensitive and specific a test is. If the reliability of a test is poor, the validity of the test may also be poor. Nonetheless, women are recommended to talk to their physicians about the benefits and risks of mammography because regular high-quality screening and clinical breast exams are the most reliable ways to screen for breast cancer. In fact, women with genetic dispositions or unhealthy lifestyles such as tobacco use would certainly alter my recommendations. I would highly suggest early mammography screening for women in their 40s with a parent or sibling with breast cancer. This type of screening may benefit early detection of breast cancer. According to Ghandi et al. (2015), it is also important to discuss their medical history before screening because false-positive results are common in younger women, women with dense breast, and women who are taking estrogen. This study source was downloaded by 100000831988016 from CourseHero.com on 04-30-2022 03:26:14 GMT -05:00 https://www.coursehero.com/file/34743436/NR503-Week-2-Screening-Reliabilitydocx/ References Gordis, L. (2014). Epidemiology (5th ed.). Philadelphia, PA: Elsevier. Ghandi, P.K., Gentry, W.M., Kibert, J.L., Lee, E.Y, Jordan, W., Bottorff, M.B., & Huang, C. (2015). The relationship between four health-related quality-of-life indicators and use of mammography and pap test screening in U.S. women. Quality of Life Research, 24, 2113-2128. doi:10.1007/s11136-015-0968-9 Loberg, M., Lousdal, M.L., Bretthauer, M., & Kalager, M. (2015). Benefits and harms of mammography screening. Breast Cancer Research, 17(1), 63. doi:10.1186/s13058-015-0525-z U.S. Preventive Services Task Force. (2014). Breast cancer: Screening. Retrieved from https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breastcancer-screening1. Hi Nichol, Thanks for your post! I think you picked an excellent screening tool for a very prevalent disease. In the past few years, there has been an increase of type 2 diabetes cases across the United States. According to the CDC (2017), almost one-third of the country have diabetes or pre-diabetes. It is also important to mention that the widespread epidemic of obesity has been prevalent during the childhood years. With the increase of processed foods, sedentary lifestyles, and more time spent in front of electronics, childhood obesity has been one of the factors for the spike of pediatric type 2 diabetes. According to Kamali, Hameed, Shih, & Simon (2017), childhood obesity is the most common chronic disease in childhood in the United States. There is a plethora of consequences of childhood obesity that have lasting long-term effects on physical, social, and emotional health. Childhood obesity poses an increased risk for poor health amongst people at an early age and contributes to the manifestation of multiple chronic diseases, including diabetes, asthma, and cardiovascular concerns. It is important to promote a healthy lifestyle as early as possible because physical activity and dietary habits formed during childhood often persist into adulthood (Burgermaster, Gray, Tipton, Contento, & Koch, 2017). Therefore, it is necessary to educate about the onset of the disease, risk factors, and nutrition in a primary care setting at a young age. Diabetes is a manageable disease that can be regulated through proper diet and adequate exercise. Diagnostic testing for diabetes mellitus is extremely important to combat future chronic illness and complications. References Burgermaster, M., Gray, H.L., Tipton, E., Contento, I., & Koch, P. (2017). Testing an integrated model of program implementation: The food, health and choices schoolbased childhood obesity prevention intervention process evaluation. Prevention This study source was downloaded by 100000831988016 from CourseHero.com on 04-30-2022 03:26:14 GMT -05:00 https://www.coursehero.com/file/34743436/NR503-Week-2-Screening-Reliabilitydocx/ Science: The Official Journal of the Society for Prevention Research, 18(1), 71-82. doi:10.1007/s11121-016-0736-2 Centers for Disease Control and Prevention. (2017). About Diabetes. Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.html. (Links to an external site.)Links to an external site. Kamali, A., Hameed, H., Shih, M., & Simon, P. (2017). Turning the curve on obesity prevalence among fifth graders in the Los Angeles Unified School District, 2001-2013. Preventing Chronic Disease, 14, 3-16. doi:10.5888/pcd14.160377 Would a breast MRI be a better diagnostic tool when looking for Cancer? Why or why not? Dr. Costello, A breast MRI has the potential to be a better diagnostic tool for women at increased risk for breast cancer, especially those with dense breast tissue. According to Losurdo et al. (2018), breast MRI has been shown to have a higher sensitivity than mammography and ultrasonography in high-risk women. It produces a more detailed MRI analysis to highlight suspicious breast regions that require further evaluation. In some situations, an aggressive breast cancer screening plan requires two or more types of imaging tests for women at highrisk. Dense breast has less fatty tissue and can be harder for mammograms to detect cancer since breast cancers are easier to see on a mammogram when surrounded by fatty tissue (Losurdo et al., 2018). A breast MRI is beneficial in that it can reveal specific characteristics, such as parenchymal enhancement of breast lesions, of breast tumors that can lead to a proper diagnosis. While screening mammograms and ultrasounds alone found only a little more than half of the cancers, breast MRI found another 8% of breast cancers not detected by the other imaging tools (Losurdo et al., 2018). It’s important to know that breast cancer screening tools can produce false-positive results, which can lead to long-term psychological and emotional distress. Therefore, a screening plan that combines multiple options, including mammograms, breast MRI, and biopsies, can provide and confirm an accurate diagnosis. Reference Losurdo, T.M., Basile, A., Fanizzi, A., Bellotti, R., Carbonara, R., Dentamaro, D., . . . La Forgia, D. (2018). A gradient-based approach for breast DCE-MRI analysis. Biomed Research International, 1-10. doi:10.1155/2018/9032408 Summary: This past week, we read about the importance of screening and diagnostic tests in identifying and conducting early prevention methods. We defined key epidemiological terms, such as validity, reliability, sensitivity, specificity, and positive predictive value, to help accurately define