HP CHO -9 October 2022
Community Health Nursing
Easy

Following is the criteria for a screening test EXCEPT:

Appeared in: HP CHO -9 October 2022

Explanation

  • The statement 'Disease should have low prevalence' is incorrect and thus the answer to this 'EXCEPT' question.
  • For a screening program to be cost-effective and efficient, the disease should have a relatively high prevalence in the population being screened.
  • Screening for a rare (low prevalence) disease results in a low positive predictive value (PPV), meaning a high number of false-positive results.
  • This leads to unnecessary anxiety, further diagnostic testing, and inefficient use of healthcare resources.
  • The established Wilson-Jungner criteria explicitly state the condition should be an important health problem, which is often correlated with high prevalence.

Why Other Options Were Wrong

  • Option A: This is a valid and fundamental criterion for screening. Resources are allocated to screen for diseases that have a significant impact on the population's health.
  • Option B: This is a critical ethical and practical requirement. It is unethical to identify individuals with a potential disease through screening without having the means to confirm the diagnosis and offer treatment.
  • Option D: This is a valid criterion. A screening program cannot succeed if the target population is unwilling to participate. The test must be acceptable in terms of comfort, convenience, cost, and cultural sensitivity.

Related Visual

An infographic summarizing the key Wilson-Jungner criteria for a successful screening program, with icons representing each point e.g., a magnifying glass for Important Health...
Clinical Relevance
  • Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Principles and criteria for public health screening programs as background academic context rather than a clinical decision trigger.
  • Nurses play a vital role in educating patients and the community about the purpose, benefits, and limitations of screening tests, including the possibility of false positives and false negatives.
  • Understanding the criteria for screening helps nurses advocate for sensible public health policies and guide patients in making informed decisions about participation.
  • What if a new, extremely cheap, and non-invasive test is developed for a rare but serious disease? Even with low prevalence, the cost-benefit analysis might shift, potentially making screening justifiable if the benefits of early detection clearly outweigh the harms of over-diagnosis and false positives.
How to Approach the Question
  • First, identify the negative keyword 'EXCEPT'. This tells you to look for the one option that is NOT a valid criterion.
  • Recall or look up the fundamental principles of public health screening, often summarized by the Wilson-Jungner criteria.
  • Evaluate each option against these principles.
  • Option A ('important health problem') is a core principle.
  • Option B ('facility for diagnosis and treatment') is an ethical necessity.
  • Option D ('acceptable to the population') is a practical necessity for participation.
Concept Tested & Keywords
  • Concept Tested: Principles and criteria for public health screening programs.
  • Stem keywords: criteria, screening test
  • Lead-in keywords: EXCEPT
  • Negative lead-in flag: The question asks for the EXCEPTION among the given options.

Question ID

QdFbuh-0v7BXUbg6RnRrZg

Reference Book

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart A (pp 26-201 of 604) p. 138-140

Practise the full HP CHO -9 October 2022

Attempt every question from this paper in a timed mock, then review the full solution for each one.