Screening Guidelines

The goal of screening is prevention, early intervention, and the management of diseases. Preventative services are studied to ensure that they do more good than harm. A test used in screening must have a high degree of Specificity and Sensitivity.

The World Health Organization offers guidelines on what determines a good screening test. In the United States, the U.S. Preventive Service Task Force determines which screening tests do more good than harm.

Institute for Clinical Systems Improvement groups preventive services based on their priority and evidence of effectiveness.

The International HapMap Project in 2005, and Human Genome Project in 2003 will enable healthcare professionals to tailer prevention programs to each patient's unique genetic makeup years in advance.

World Health Organization

Classic Screening Guidelines

  1. Should be an important health problem
  2. There should be a treatment
  3. Facilities should be available
  4. Should be a latent stage of the disease
  5. Should be a test or examination
  6. Test should be acceptable
  7. The disease should be understood
  8. Should be a policy on who to treat
  9. Cost of finding a case should be balanced
  10. Case-finding should be a continuous
Current Screening Guidelines
  1. Should respond to a recognized need
  2. Objectives should be defined at the outset
  3. Should be a defined target population
  4. Should be scientific evidence of effectiveness
  5. Should integrate education, testing, services, and management
  6. There should be quality assurance
  7. Should ensure informed choice, confidentiality, and autonomy
  8. Should promote equity, and access
  9. Evaluation should be planned from the outset
  10. Benefits of screening should outweigh the harm

U.S. Preventive Service Task Force

Grades* and Quality of Evidence Ratings
  1. A - Strongly Recommended to offer service
  2. B - Recommended to offer service
  3. C - No Recommendation on service
  4. D - Not Recommended to offer service
  5. I Statement:   - Insufficient Evidence

  6. * Graded with levels of certainty regarding the net benefit

Institute for Clinical Systems Improvement

Ranking Is Based On Priority And Evidence Of Effectiveness
  • Level 1 - Providers and healthcare systems MUST assess the need for and offer to each patient. These have the highest priority value. and are worthy of attention at every opportunity
    		•
  • Level 2 - Providers and healthcare systems SHOULD access the need for and offer to each patient. These have value but less than those in level 1
    		•
  • Level 3 - Evidence is currently incomplete and/or high burden of disease and low cost of delivering the care. Providing these services is left to the judgement of providers and healthcare systems
    		•
  • Level 4 - Not supported by evidence and are not recommended
    		•

    International and National Human Genome Project

    Genome.gov National Human Genome Research Institute National Institutes of Health

    With the completion of the Human Genome Project in 2003 and the International HapMap Project in 2005, researchers now have a set of research tools that make it possible to find the genetic contributions to common diseases.

    In the near future, healthcare professionals will be able to predict the risk of disease based on genetic markers, providing individualized information about the risk of developing certain disease years before it starts, enabling healthcare professionals to tailor prevention programs to each patient's unique genetic makeup years in advance.