Being precise about screening vs. diagnostic tests


Gary Schwitzer, AHCJ member and publisher, calls for more precise language when describing medical tests and to make a bit of an example of Prevention magazine on his blog. The March issue of the magazine leads with a story titled “4 Screening Tests Women Fear.” The problem? The story’s about mammograms, colonoscopies, endoscopies and MRIs. And two of those things, Schwitzer writes, are not like the others. Emphasis mine.

…Only 2 of the 4 tests discussed are screening tests.

Yes, mammograms and colonoscopies are screening tests – used in an apparently healthy population looking for signs of trouble.

Endoscopies and MRI scans — as discussed by Prevention in this case — are not screening tests but diagnostic tests used to help diagnose what is the problem in people with signs or symptoms of something wrong. Screening tests are for people believed to be healthy. Diagnostic tests are for people believed to have a problem.

Schwitzer’s not just splitting hairs here. As he explains, getting these distinctions right can have real-world health impact.

The semantics are important. Lumping diagnostic tests like endoscopy and MRI in with screening tests like mammograms and colonoscopies can give readers the impression that everyone should consider all of them. And, no, not everyone needs to be worried about when to have their next endoscopy or MRI scan…

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