What Makes a Screening Exam "good"?

Location of recurrent asymptomatic ovarian cancer through endoscopic ultrasound

“…In 2006, Herman published characteristics of a good screening examination: one that can detect a high proportion of disease in its preclinical state, safe to administer, at a reasonable cost, provide improved health results and be widely available. [ 14 ] Due to anatomic limitations, the upper digestive EUS does not give access to all possible relapse sites and certainly would not detect, in high proportions, a recurrence of ovarian cancer, rating it as unfit in some of the established criteria.…”

Decision aid for the use of additional tests during the pre-employment medical examination (PEME) of seafarers

“…For example, in a seafarer with hypertension, the level at which one would start treatment is lower than the level at which a seafarer would be seen as unfit to go to sea. National guidelines such as those published by the National Institute of Health and Care excellence in the United Kingdom [4] suggest that a blood pressure of greater than 140/90 mm Hg requires further investigation and possible factors, in accordance with accepted criteria for evaluation of screening tests [9]. The criteria for a beneficial screening programme and screening test that focuses on detecting disease at an asymptomatic stage to facilitate secondary prevention is shown in Table 1.…”

“…Such mitiga- Table 1. Criteria for screening programmes and screening tests used for detecting disease for the purpose of secondary prevention [9] For a screening programme to be beneficial the disease in question should be • Common with significant morbidity/mortality • Readily treatable with a potential cure that increases with early detection and that is available to all…”

Current landscape of prenatal genetic screening and testing

“…In pregnancy specifically, an appropriate screening test should be able to identify either common or significant fetal disorders and/or anomalies or provide reassurance for women with pregnancies that are not affected. The tests should be cost-effective and easy to administer, be reliable and reproducible, and have a high detection rate that does not sacrifice a low false positive rate in its stead (Herman, 2006). A good screening test should have a definitive diagnostic test and, as is the case in perinatal medicine, it should be available in early gestation to allow for potential pregnancy intervention, such as termination of pregnancy or surgical intervention for select fetal abnormalities, as well as allow for pregnancy management considerations such as delivery planning, financial planning, and emotional and psychological adaptation.…”