Evaluating Health Screening Procedures

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Abstract
The various objectives and means used in screening populations for disease conditions are briefly presented. Detailed consideration is given to the evaluation of screening done primarily to improve the health status of the screened community. Alternative numerical methods of measuring health benefits are given. The many variables that are subject to control by authorities directing the screening program are listed. A model is formulated for determining the optimum level at which the result of a test should be considered as positive (resulting in recall of the screened person for further diagnostic study). The proposed model is compared with other evaluation methods in use. Data from a diabetes survey are used as an example. The optimum level for screening is shown to depend not only on the biological characteristics of the test, but also on (1) the relative health value to the screened community of true and false positives and negatives, and (2) the prevalence of the disease condition in the population screened.

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