problems of borderline
TRANSCRIPT
PROBLEMS PROBLEMS OF OF
BORDERLINEBORDERLINE
By Sneha Raj . PRoll No 94Guided By:
Sipra Madam
Which of the following is more important in screening..??
Sensitivity or specificity No categorical answer can
be given
Shaded area → persons with disease + Persons without disease
• E is frequently used as cutoff point
• E minimizes false positives and false negatives
Many physiological variables show this type of distribution
No sharp dividing line Borderline group contains
homogenous sample of persons
Blood Pressure & Blood Sugar
• Cutoff point increases - sensitivity decreases • Cutoff point decreases - sensitivity increases• In screening for disease a prior decision is made about the cutoff point
Factors Considered In Fixing A Cutoff Point• Disease prevalence • Disease
Disease prevalence: If disease prevalence is increased- screening is set at low level- sensitivity is increasedDisease: Lethal disease Prevalent diseases
OTHER PROBLEMS:1.People who participate in screening program may not be those who have most to gain from it2.More expensive & time consuming test..
3.Screening should not be done in isolation.It should be integrated into existing health services.
4. Risks as well as expected benefits must be explained to people to be screened.
14
Screenes
Well
Asymptomatic Sick
Sick
15