Ethical issues and cancer screening.pptVIP

Ethical issues and cancer screening Efficacy The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally the determination of efficacy is based on the results of a randomised controlled trial. Last JM (ed). A Dictionary of Epidemiology. Third edition New York: Oxford University Press, 1995. Effectiveness The extent to which a specific intervention, procedure, regimen, or service, when deployed in the field in routine circumstances, does what it is intended to do for a specified population. Last JM (ed). A Dictionary of Epidemiology. Third edition New York: Oxford University Press, 1995. Assessing the Efficacy of Screening Lead-time bias Length bias Selection bias Overdiagnosis bias Screened X X death Not screened X X death Disease begins Screen diagnosis Signs/symptoms Screened X X death Not screened X X death Disease begins Screen diagnosis Signs/symptoms Survival time __________ ____________________________ _______________ __________ ___________ ______ ________________________________ ________ _____________ ________ ____ _______ _________ ____________________ _____ _______ ___________ ___________ _________________________ _____________ Horizontal lines represent the pre-symptomatic screen-detectable phase in various individuals  screen screen __________ ____________________________ _______________ __________ ___________ ______ ________________________________ ________ _____________ ________ ____ _______ _________ ____________________ _____ _______ ___________ ___________ _________________________ _____________