Screening Is a Process

Understanding the literature on the benefit of screening in average-risk populations is a necessary step toward evidence-based practice, but it is only the beginning. Although there is a great deal of discussion about the various screening tests, it is really the entire screening process that matters. The test is only one part of a screening process that begins with the recruitment of eligible people and continues by conducting the screening test, evaluating those with positive results, and treating those with disease (Figure 24.1).12 A successful screening process means mortality is reduced because those steps and transitions occur. For example, the proportion of people who make the transition from a positive test to evaluation and treatment varies between 27% and 93%, depending upon the screening test, the person's insurance status, patient and provider factors, and the organization of the healthcare setting in which the test is administered.13 Making sure that transition occurs is the final subject of this chapter, and it is clear that without it screening cannot have an impact on mortality.

chapter 24

Screening Process

Outcomes

Risk Assessment

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