NR 503 Week 2: Discussion- Screening and Reliability ORDER NOW FOR ORIGINAL PAPER
NR 503 Week 2 Discussion
Week 2: Descriptive Epidemiology, Screening, Prevention and the Importance of the Randomized Control Trial
NR 503 Week 2: Discussion- Screening and Reliability
From the U.S. Preventive Task Force website https://www.uspreventiveservicestaskforce.org/BrowseRec/Index (Links to an external site.)Links to an external site., choose one screening test that might be considered in primary care.
Define the test, its positive predictive value, reliability and validity. Discuss patient medical or family history that may alter your recommendation for screening?
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NR 503 Week 2: Discussion- Screening and Reliability SAMPLE INTRO
The screening test that I chose is Type 2 Diabetes Mellitus (DM). Healthy People 2020 (2018) states diabetes is one of the significant public health problems and the 7th leading cause of death in the United States. At workplace, I even get to see many patients who didn’t control their glucose levels and ended up getting emergency or intensive care units due to high blood sugar levels such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). The complications of diabetes cause cardiovascular disease, however modifiable cardiovascular risk factor such as abnormal blood glucose is considered to be preventable if the levels of hemoglobin A1c, fasting plasma glucose level, and OGTT are under control (Nathan, 2015). This screening test detects abnormal glucose level by measuring HbA1c, fasting plasma glucose or with an oral glucose tolerance test (USPSTF, 2015). According to data from U.S. Preventive Services (2015), patients with glucose for Hemoglobin A1c level is higher than 6.5%, fasting plasma glucose level is higher than 7.0 mmol/L, and OGTT results is higher than 11.1 mmol/L are often considered positive for diabetes type 2. Positive predictive value (PPV) is the percentage of patients with a positive test who actually have the disease (Gordis, 2014). It tells us how many of test positive are true positives and this number is as close to 100 as possible (Thomas, Parikh, Mathai, Parikh, Sekhar, & Thomas, 2008). If the number is higher, it indicates that the test gives us the correct results. When calculating PPV, sensitivity, and specificity are used. Sensitivity is the ability of a test to correctly classify an individual as ‘diseased’ and specificity is the ability of a test to correctly identify those who do not have the disease (Thomas, Parikh, Mathai, Parikh, Sekhar, & Thomas, 2008). Formula of PPV is True positive / true positive + false positive.
NR 503 Week 2: Discussion- Screening and Reliability SAMPLE RESPONSE
Thank you for your post, I enjoyed reading it. The screening test that you chose is very important in screening for Diabetes Mellitus. Type 2 Diabetes Mellitus is a major health problem and leading cause of death in our country. Like you, I have many patients who do not control their diabetes and end up in the ICU with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS), as well as amputations of the extremities, neuropathy, cardiovascular disease, etc. I also think you did a great job of discussing positive predictive values (PPV), validity, sensitivity, and specificity. Also, as you mentioned, family history is a big factor to consider regarding testing, especially in close relatives. As primary care providers, it is important for APNs to carefully consider testing for Type 2 Diabetes Mellitus and family history definitely plays an important role. Thank you for your informative post on screening for Type 2 Diabetes Mellitus.
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