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S S NG LC BNH SCREENING

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S S NG LC BNH SCREENING

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    1. S? SNG L?C B?NH ( SCREENING) PGS,TS L HONG NINH

    2. I. ?I CUONG ?nh nghia : Sng l?c b?nh: qui trnh tch nh?ng d?i tu?ng nguy co/ c kh? nang m?c b?nh trong c?ng d?ng d? c bi?n php can thi?p thch h?p nham ngan ng?a b?nh t?t xy ra trn cc d?i tu?ng nguy co Sng l?c nh?m pht hi?n cc di tu?ng nguy co s?m Cng c? sng l?c = test sng l?c

    3. I. ?I CUONG Cc d?ng snh l?c: Sng l?c d?i tr ( mass screening) Sng l?c nhi?u giai do?n = da sng l?c ( multiple hay multiphaseic screening) : s? d?ng nhi?u test khc nhau trn m?t d?i tu?ng Sng l?c theo m?c tiu ( target screening): sng l?c trn nhm dn s? c ti?p xc d?c bi?t Sng l?c co h?i hay sng l?c pht hi?n b?nh ( case-finding hay opportunistic screening) sng l?c trn b?nh nhn

    4. II. Cc tiu chu?n cho m?t chuong trnh sng l?c Tiu chu?n v? b?nh: Tr?m tr?ng Ti?n lm sng ph? bi?n Bi?t ti?n trnh t? nhin c?a b?nh Giai do?n t? tri?u ch?ng so kh?i t?i ton pht di

    5. II. Cc tiu chu?n cho m?t chuong trnh sng l?c 2. Tiu chu?n v? test sng l?c: Nh?y v d?c hi?u on gi?n/ r? ti?n Ch?p nh?n du?c 3. Tiu chu?n v? ch?n don v di?u tr? Tin c?y Thu?n l?i Hi?u qu? An ton u?c ch?p nh?n

    6. III. Ti?n trnh t? nhin c?a b?nh X---------*----------------****----------?+ X = ti?p xc m?i nguy * b?t d?u c r?i lo?n sinh h?c **** : h?i ch?ng lm sng xu?t hi?n + t? vong Giai do?n pht hi?n ti?n lm sng: *------?****

    7. IV. TEST SNG L?C ?c tnh c?a b?nh Test sng l?c : Tnh gi tr? : gip tch ra, nh?n ra cc d?i tu?ng nguy co m?c b?nh trong c?ng d?ng d? can thi?p Tnh tin c?y: cho k?t qu? # nhau sau khi l?p l?i trn cng m?t d?i tu?ng

    8. Tnh gi tr? c?a test sng l?c ? nh?y : kh? nang test duong trn s? ngu?i b? b?nh : Sensitivity = a / ( a + c) ? d?c hi?u: kh? nang test m trn s? ngu?i khng b? b?nh Specificity = d / ( b + d)

    9. Tnh gi tr? c?a test sng l?c Gi tr? tin don duong: kh? nang b? b?nh trn nh?ng ngu?i c k?t qu? test duong ( p v +) = a / ( a + b) Gi tr? tin don m: kh? nang khng b? b?nh trn nh?ng ngu?i c k? qu? test m ( pv - ) = d / ( c + d)

    10. Tnh gi tr? c?a test sng l?c B?ng 2 x 2: ------------------------------------------------------ b?nh T?ng c khng ------------------------------------------------------ duong a b ( a + b ) Test m c d ( c + d ) ----------------------------------------------------- T?ng (a + c) ( b + d) ( a + b+c+d)

    11. Quan h? gi?a d? nh?y v d?c hi?u ? nhay : Se = a / ( a + c) trong d c = m gi? ( m sai) ? d?c hi?u: Sp = d / ( b + d) trong d b = duong gi? ( duong sai) Nh?y ?? d?c hi?u Nhay nn tang : H?u qu? b? st : tr?m tr?ng v di?u tr? t?t B?nh lan truy?n d? d?i nh gi k?t qu? test sng l?c r?, t nguy o Gi?i quy?t mi quan h? : ? Nhi?u test cng lc/ test theo th? t?

    12. Tnh tin c?y c?a test sng l?c Tnh tin c?y: h? nang test cho cng m?t k?t qu? khi test du?c lm l?i nhi?u l?n trn m?t ngu?i trong cng m?t di?u ki?n 4 ngu?n ?nh hu?ng d?n tnh tin c?y: Bi?n d?i sinh h?c D?ng c? do lu?ng Ngu?i do Nhi?u ngu?i do

    13. IV. NH GI CHUONG TRNH SNG L?C TNH KH? THI: Ch?p nh?n v gi thnh KH? NANG PHT HI?N B?NH: Gi tr? tin don TNH HI?U QU? Gi?m s? m?c/ s? ch?t ? CC THI?T K? NH GI Tuong quan : t?n s? sng l?c v t? l? b?nh B?nh ch?ng on h? Th? nghim lm sng ng?u nhin

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