Epidemiology

The test is: Pap Smear

2pg and 1 chart
Recent sources not older than 5years (2016-2020)

Choose one diagnostic test on which to base your assignment.
Create a 2 x 2 table to compute the sensitivity and specificity of this diagnostic study.
Describe the implications of the sensitivity and specificity you calculated for this diagnostic study.
Based on your 2 x 2 table and the computed sensitivity and specificity for this diagnostic study, what information would you share with a colleague about whether or not to use this diagnostic study?
Reflect on and describe your greatest area of learning from this assignment.
The idea is that you understand the concept of a diagnostic test/study sensitivity and specificity.

Rubric Guidelines:
Choose one diagnostic test for which to base your assignment.
For Example, lipoprotein-cholesterol measurements (I chose Pap Smear)
Create a 2 x 2 table to compute the sensitivity and specificity of this diagnostic study.
You would create a table based on the following information:
Sensitivity was 93%
Specificity was 85%
There is guidance in the Gordis text on how to create a 2 x 2 table and I also include PPT slides to help you better understand this concept and how to create a 2 x 2 table based on this sensitivity and specificity. (https://www.youtube.com/watch?v=Doa_QqtAexU&feature=emb_logo)
Describe the implications of the sensitivity and specificity you calculated for this diagnostic study.
Describe the implications of having a test with a sensitivity of 93% and specificity of 85%. For example, how confident are you or how confident can you be about using a fingerstick method to measure and assess lipoprotein-cholesterol measurements?
Based on your 2 x 2 table and the computed sensitivity and specificity for this diagnostic study, what information would you share with a colleague about whether or not to use this diagnostic study?
For example, think about false positives and false negatives?
What does this mean for the patients who get these results?
What kinds of ethical concerns or worries are presented for patients who get a false positive or a false negative?
For example, if you thought you had high cholesterol but did not, how would you be impacted? Could any harm come to you or not? If you thought your cholesterol was in the normal range and you did not make any changes based on the false negative, what kinds of harmful outcomes or impacts might this have?
Reflect on and describe your greatest area of learning from this assignment.

Epidemiology Week 3 Assignment

Health care providers use numerous test to diagnose different conditions, with the best being those with the highest level of sensitivity and specificity. Sensitivity is the ability of a test to fittingly define the patients, which means that a test that identifies all positives in any given sample correctly is considered to be very sensitive (Baratloo et al., 2015). On the other hand, specificity refers to the ability to define healthy cases in a given sample, which means a test that identifies all healthy people as negative in terms of a particular illness is considered to be specific. Although various cervical cancer tests exist whose specificity and sensitivity can be measured to determine its suitability in diagnosing the illness, the pap smear test has the highest specificity and sensitivity.

In a hypothetical case, two equal samples panels of 100 positives, and 100 negatives were used. The results of the tests are presented in the following table, together with the outcomes of their sensitivity and specificity measures.

Sensitivity= TP/TP+FN

93/ (93+7)

93/100

=0.93 in percentage 93%

Specificity

TN/ (TN+FP)

=85/85+15,

85/100

=0.85 in percentage=85%

Implications of the Sensitivity and Specificity for the Diagnostic Study

The outcome of a test is critical since it informs the course of treatment. According to the outcomes of the analysis, the Pap smear test could detect that 93 individuals out of a sample of 100 were sick or unhealthy. However, the other 7 were considered healthy even though they were not. Therefore, the sensitivity level of the test was 93%. The test could also detect that 85 of these were healthy while the rest 15 individuals were deemed unhealthy or were falsely labeled as having cervical cancer even though they were healthy. Therefore, the test specificity was 85%. The results had numerous moral implications since they could be used to update treatment.

One of the ethical implications of low sensitivity levels of this test is that, it could not accomplish the objectives of early disease detection. The effectiveness of any given test is to detect disease early enough to reduce mortality and morbidity rates (Maxim, Niebo & Utell, 2014). Therefore, the lack of a 100% sensitivity level means that seven individuals out of a 100 sample could have the disease and risk death since they were undetected. The test may have given the individuals a misleading impression that they were healthy, causing them to miss more diagnostic tests. The outcome could also have delayed the correct diagnosis for the seven individuals, reducing their chance of recovering. As for the healthy people and the specificity analysis, the test could have subjected 15 people to the mental torture of living with the fear that they have a disease that they did not have. Thus, the results have critical implications in the diagnosis of a serious disease, such as cancer.

Another implication of the results is the cost of diagnosis and treatment to the individual, and the hospital. The low sensitivity and specificity could also have been costly; for healthy people, the test could result in death from taking medications for a wrong diagnosis (Bujang & Adnan, 2016). For example, 15 people could have been subjected to agonizing chemotherapy sessions, even though they did not have cervical cancer. The cost could be borne by the hospital, and the affected person.

Lesson Learned

Various lessons are evident in the hypothetical case of sensitivity and specificity of a pap smear in testing cervical cancer. For example, the best test is that which has a 100% sensitivity and specificity levels. However, since this is not always possible, health care providers should use more than one medical diagnosis of any condition (Resch et al., 2016). The use of more than one test will protect people from mental torture due to misdiagnosis or late diagnosis that can cause death.

Conclusion

From the description of the sensitivity and specificity levels, the best test is that which has the highest levels of both. False positives can cause mental torture to healthy individuals, while false negatives may delay disease diagnosis. Therefore, more tests are needed to avoid the negative implications caused by low sensitivity and specificity levels.

References

Baratloo, A., Hosseini, M., Negida, A., & El Ashal, G. (2015). Part 1: Simple Definition and Calculation of Accuracy, Sensitivity and Specificity. Emergency (Tehran, Iran), 3(2), 48–49.

Bujang, M. A., & Adnan, T. H. (2016). Requirements for minimum sample size for sensitivity and specificity analysis. Journal Of Clinical And Diagnostic Research, 10(10).

Maxim, L. D., Niebo, R., & Utell, M. J. (2014). Screening tests: a review with examples. Inhalation Toxicology, 26(13), 811–828.

Resch, J. E., Brown, C. N., Schmidt, J., Macciocchi, S. N., Blueitt, D., Cullum, C. M., & Ferrara, M. S. (2016). The sensitivity and specificity of clinical measures of sport concussion: three tests are better than one. BMJ Open Sport & Exercise Medicine, 2(1), e000012.

Order an Essay Now & Get These Features For Free:

Turnitin Report

Formatting

Title Page

Citation

Outline

Place an Order