CRITERIA FOR SCREENING

GUIDED BY : DR DINPRAKASH RANJAN

PRESENTED BY : VISHALU S GADAG

• Criteria for screening based on two
considerations:

the DISEASE to be screened, and

the TEST to be applied

Disease
The disease to be screened should
fulfill the following criteria before it is
considered suitable for screening:
1.the condition sought should be an important
health problem;
2.There should be a recognizable latent or early
asymptomatic stage;
3.The natural history of the condition, including
development from latent to declared disease,
should be adequately understood;
4.There is a test that can detect the disease prior
to the onset of signs and symptoms;
5.Facilities should be available for confirmation of
the diagnosis;
6.There is an effective treatment;
7.There should be an agreed-on policy concerning
whom to treat as patients;
8.There is good evidence that early detection and
treatment reduces morbidity and mortality;
9.The expected benefits of early detection exceed
the risks and costs.
Screening test
The test must satisfy the criteriaof- acceptability
-repeatability &
-validity
1.Acceptability
since a high rate of cooperation is necessary, it is
important that the test should be acceptable to
the people at whom it is aimed.
2.Repeatability
the repeatability of the test depends upon three
major factors, observer variation
biological variation and(subject)
errors relating to technical methods
A.Observer variation
two types :
a.intra observer variation
if a single observer takes two measurements in
the same subject ,at the same time and each time,
he obtained a different result, this is termed as
intra – observer or within – observer variation.
b.inter-observer variation
this is variation between different observers on
the same subject or material , also known as
between-observer variation.

this variation has occurred if one observer

examines a blood smear and finds malaria
parasite, while a second observer examines the
same slide and finds it normal.
B. Biological or subject variation
The fluctuation in the same individual may be due
to - a)changes in the parameters observed
b)variations in the way patients percieve their
symptoms and answer , this is common subject
variation
c)regression to the mean
 whereas observer variation may be checked by
repeat measurements at the same time,
Biological variation is tested by repeat
measurements over time.
C.Errors relating to technical methods
lastly , repeatability may be affected by variations
inherent in the method, e.g., defective instrument
Errroneous caliberation, faulty reagents; or the
test itself might be inapproppriate or unreliable.
3.Validity (accuracy)
the term validity refers to what extent the test
accuracy measures which it purports to measure.
in other words , validity expresses the ability of a
test to separate or distinguish those who have the
disease from those who do not .

validity has two components –sensitivity &

specificity. When assessing the accuracy of a
diagnostic test , one must consider both these
components.
Sensitivity and specificity are usually determined
by applying the test to one group of persons
having the disease and to a reference group not
having the disease.
THANK YOU…