Report in English with a Dutch summary (KCE reports 45A)

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12 Screening for Colorectal Cancer KCE reports vol.45 into a category other than that to which it should be assigned. Morbidity Illness. The number of deaths from a specified disease that are diagnosed or Mortality rate reported during a defined period of time in a given population. Multiple Analysis of data that takes into account a number of variables regression simultaneously. Natural history The course of a disease from onset to resolution. Negative The probability a person does not have the disease when the screening predictive value test is negative. The number of patients who would need to be screened, for a given period of time, in order to prevent a single event (i.e. death from Number needed colorectal cancer). The smaller the NNS, the fewer people need to be to Screen screened to prevent an event. The NNS often varies markedly with risk factors such as age and in general with incidence of the disease in that population. The number of patients who must be exposed to an intervention Number Needed before the clinical outcome of interest occurs; for example, the to Treat number of patients needed to treat to prevent one adverse outcome. A proportion in which the numerator contains the number of times an Odds event occurs and the denominator includes the number of times the event does not occur. Odds ratio A measure of the degree or strength of an association. In a case Cross-product control or a cross-sectional study, it is measured as the ratio of the ratio odds of exposure (or disease) among the cases to that among the Relative odds controls. The key feature that distinguishes opportunistic screening from screening programs is the lack of a quality process, including routine monitoring and evaluation. Opportunistic screening usually occurs when a person who is presenting to the health system for another Opportunistic reason is asked a question or offered a test in order to detect the screening presence or confirm the absence of a specific condition. Opportunistic screening may be organised to a greater or lesser degree. However, because there are no attendant quality processes, its safety, effectiveness and costeffectiveness cannot be assessed and guaranteed. A person who goes to a health care facility for a consultation, and who Outpatient leaves the facility within three hours of the start of the consultation. An outpatient is not formally admitted to the facility. A population-based screening program is one in which screening is Population based systematically offered by invitation to a defined, identifiable population; screening this requires a means of identifying and inviting the target population, program for example through a population register. Population screening programs involve screening entire populations or a large and easily identifiable group within a population. The target Population population group for screening may be defined geographically or by screening some other characteristics such as gender, age or ethnicity. The New programs Zealand cervical and breast screening program are examples of population screening programs. Positive The probability that a person actually has the disease when the predictive value screening test is positive. Power The ability of a study to demonstrate an association if one exists. The range in which the best estimates of a true value approximate the Precision true value. In screening and diagnostic tests, the probability that a person with a Predictive value positive test is a true positive (i.e., does have the disease), or that a
KCE reports vol.45 Screening for Colorectal Cancer 13 Prevalence Primary care Prognosis Prognostic factor person with a negative test truly does not have the disease. The predictive value of a screening test is determined by the sensitivity and specificity of the test, and by the prevalence of the condition for which the test is used. The number of events in a given population at a designated time (point prevalence) or during a specified period (period prevalence). First contact, continuous, comprehensive and coordinated care provided to individuals and populations undifferentiated by age, gender, disease or organ system. the possible outcomes of a disease or condition and the likelihood that each one will occur. Demographic, disease-specific, or co-morbid characteristics associated strongly enough with a condition's outcomes to predict accurately the eventual development of those outcomes. Compare with risk factors. Neither prognostic nor risk factors necessarily imply a cause and effect relationship. Study design where one or more groups (cohorts) of individuals who Prospective study have not yet had the outcome event in question are monitored for the number of such events which occur over time. Providers Organisations and health professionals providing health services. A sample that is arrived at by selecting sample units in such way that Random sample Randomised controlled trial Recall bias Reference standard Referral filter bias Relative risk Relative risk reduction Reliability Repeatability Reproducibility each possible unit has a fixed and determinate probability of selection. An epidemiologic experiment in which subjects in a population are randomly allocated into groups - rather than by conscious decisions of clinicians or patients - to receive or not receive an experimental preventive or therapeutic procedure, manoeuvre, or intervention. Randomised controlled trials are generally regarded as the most scientifically rigorous method of hypothesis testing available in epidemiology. If the sample size is large enough, this study design avoids problems of bias and confounding variables by assuring that both known and unknown determinants of outcome are evenly distributed between treatment and control groups. Systematic error due to the differences in accuracy or completeness of recall to memory of past events or experiences. An independently applied test that is compared to a screening or diagnostic test being evaluated in order to verify the latter s accuracy. A reference standard, therefore, provides an accurate or truth diagnosis for verification of positive and negative diagnoses. It is sometimes described as providing final truth determination . The sequence of referrals that may lead patients from primary to tertiary centres raises the proportion of more severe or unusual cases, thus increasing the likelihood of adverse or unfavorable outcomes. The ratio of the risk of disease or death of those exposed to the risk compared to the risk among those unexposed, in a specified period of time. It is a measure of the strength or degree of association applicable to cohort studies and RCTs. The proportional reduction in rates of events between experimental and control participants in a trial. If there was an increase in the rate of events in the experimental group, the term would then be relative risk increase. The results of a test or measure are identical or closely similar each time it is conducted. Repeat screening Rescreening offers made only to persons completing a prior test or
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KCE reports 1. Effectiviteit en kos
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