QUESTION DESCRIPTION

Each reply should be at least 200–250 words and should adhere to AMA writing guidelines. Each reply must include one reference to support the information you present. ( scholarly and biblical reference as well)

classmate #1-

Reliability of Diagnosis? Explain

The importance of epidemiology to society is the quest to help discover the cause of disease in populations¹. One of the objectives of screening test is to reduce morbidity and mortality in the population being screened through early detection². Reliability of a test is when a test yields consistent results (positive or negative)¹. The question to consider is whether the two physicians diagnosed the same 100 patients with cataracts. If they did not diagnose the same 100 patients with cataracts, the diagnoses may not be reliable. Reliability is an important tool in screening and treating patients. When a measuring instrument is able to give consistent results after repeated trials on the same individual, the test is considered reliable.

How does reliability affect screening and treatment programs for a condition?

Screening is utilized in health care as a detective tool. A diagnostic test may find out what the cause of symptoms may be but a screening test could be used routinely to detect or prevent a condition. For example, all newborns are screened for hearing after 24 hours of life. To determine reliability in the hearing screen example, we will get the same results after a repeated screening is done. After reliability is confirmed, a suitable treatment is initiated. To get unbiased results during treatment, a screening should be reliable and valid¹. Validity refers to a measuring instrument’s ability to give true measure¹. When results are unreliable and invalid, appropriate treatment may be omitted or given as an option by some physicians. A patient may also not be aware of the risk versus benefit of non-treatment which can contribute to future morbidity or mortality.

What are the socio-political ramifications of understanding reliability prior to implementing a screening program?

Unreliable screening tests create unnecessary stress, fear and misdiagnoses. Imagine being screened for a reportable sexually transmitted illness or a communicable disease like Tuberculosis. Without repeated testing, reliable and valid test, a person misdiagnosed can feel socially isolated, politically suppressed and they can avoid further testing and treatment. Another issue of concern is disability in persons when there is a lack of understanding of screening³. Reliability serves as a confirmatory screening test which can help communities to thrive or get results needed.

References

1. Friis RH, Sellers TA. Epidemiology for public health practice. 5^th ed. Burlington, MA: Jones & Bartlett Learning; 2014.
2. Maxim LD, Niebo R, Utell MJ. Screening tests: a review with examples. Inhalation Toxicology. 2014; (26)13: 811-828 doi: 10.3109/08958378.2014.955932
3. Kim JH, Jong-Hun, Cheong HK, et al. The validity and reliability of a screening questionnaire for Parkinson’s Disease in a community. Journal of Preventive Medicine and Public Health, Korean Society for Preventive Medicine. 2010; 43(1). doi:10.3961/jpmph.2010.43.1.9.

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classmate #2-

Cataracts can lead to vision loss, reduced quality of life, and increased rate of falls.³ Therefore, it is important to find data that is reliable and valid. Therefore, it is critical to take the diagnoses and treatment of so with care. In the study, two physicians examined 1,000 eyes, in which they each found 100 eyes with cataracts. Reliability, also known as precision, refers to the “ability of the measuring instrument to give consistent results on repeated trials”.¹ If the two physicians both found 100 eyes with cataracts, the data is consistent. However, the validity of the data may be questionable. As data can be reliable and not valid.^1,2Furthermore, one would have to validate the data and corroborate that the same 100 eyes had the cataracts. As if the two physicians found cataracts in any number of different eyes, the data could be construed as unreliable.

Reliability is critical in regard to screening and treatment programs for a variety of reasons. First, just because something is of a high reliability score, does not mean that it is highly accurate.¹ It may also be of importance to draw attention to validity in regard to screening and treatment programs, as validity refers to the “ability of a measuring instrument to give a true measure”.¹ Furthermore, it is important to note that it is not possible for a measure to be valid, but unreliable.¹ However, it is possible for a measure to be reliable and valid.¹ Creation and implementation of a program solely off of reliability and not validity may be a cause for concern, as one may be utilizing data that is not accurate.

Socio-political ramifications of understanding reliability prior to implementation of a screening program is crucial. As if the data is reliable, yet not valid, individuals could be affected socially. As it may take an emotional toll for an individual whom was told they have cataracts, yet do not. As well as financial implications, as individuals may have to pay a large deal for tests that are unnecessary. Political ramifications due to screening programs in which were the basis of reliable yet invalid data may also be prominent. As increased vulnerability of groups may be a result (i.e. racial, gender).⁴

“Trust in the LORD forever, For in GOD the LORD, we have an everlasting Rock” Isaiah 26:4. Trust in the future and the plans for which he has. Whether this be through work or personal life. In this scenario, trust that the Lord has a plan for whatever occurs in regard to screening programs and assisting the needy.

References:

1. Friis RH, Sellers TA. Epidemiology for Public Health Practice. 5^th ed. Burlington, MA: Jones & Bartlett Learning; 2014.
2. Vollmer TR, Sloman KN. Practical Implications of Data Reliability and Treatment Integrity Monitoring. Behav Anal Pract. 2008;1(2):4-11. Doi: 10.1007/BF03391722. Accessed February 18, 2019.
3. Hodge W, Horsley T, Albiani D, Baryla J, Belliveau M, Buhrmann R, et al. The consequences of waiting for cataract surgery: a systematic review. CMAJ. 2007;176(9):1285-1290. Doi: 10.1503/cmaj,060962. Accessed February 18, 2019.
4. Stoto MA, Almario DA, McCormick MC. Reducing the odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: National Academy Press; 1999.https://www.nap.edu/read/6307/chapter/1. Accessed February 18, 2019.