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C-I-S: Residency

DIAG2-R Deciding If and When To Screen or Test (R004-DIAG2)


Description
Just because a screening or diagnostic test is available doesn't mean it should be ordered for a patient. This module walks through the risks of indiscriminate use of tests, including the detrimental effect of false positive tests and the consequences of early diagnosis of disease and the concept of overdiagnosis.
Content
  • Introduction
  • Welcome and Introduction
  • Objectives
  • The Level of "POEMness" of a Test
  • Hazards of Inappropriate Testing
  • Ordering a Test or Imaging: Not a Benign Event
  • Making a Diagnosis: Labeling is Not Enough
  • Using Bayes' Theorem in Clinical Practice
  • A little More About Bayes' Theorem
  • Testing Does Not Reassure Patients and Can Increase Anxiety
  • Unintended Psychological Effects of Test Results
  • Inappropriate Testing Example: The Case of Baby Jeff
  • The Case of Baby Jeff
  • Test Characteristics: CPK testing for Muscular Dystrophy
  • Calculating Baby Jeff's Likelihood of Muscular Dystrophy
  • The Effect of Inappropriate Testing
  • Overuse and MIsuse of Screening Tests
  • What is the Value of Screening Tests?
  • Is Early Detection of Disease Always Helpful?
  • The Critical Point: Why Early Disease Detection Isn't Always Beneficial
  • The Birds, Turtles, and Rabbits Metaphor of Screening for Disease
  • Lead Time Bias and How It Can Make a Screening Test Look Better than It is
  • Hazards of Inappropriate Diagnosis/Overdiagnosis
  • Harms Associated with Early Diagnosis
  • Some Examples of High False Positive Results
  • Hazards of False Positive Results
  • False Positive Rate with Mammography - Why?
  • The Importance of Evaluating All-Cause Instead of Disease-Specific Mortality
  • Screening Tests and The Risk Of Overdiagnosis
  • Wrap-up
  • Dave and Allen Unplugged: Too Much Medicine
  • Wrap-Up and a Moment for Reflection
Completion rules
  • All units must be completed
  • Leads to a certificate with a duration: Forever
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