Bonaldi A, Negri A, Angioletti R, Focarile F
Servizio di Assistenza Sanitaria di Base, USL 32 Treviglio.
Epidemiol Prev. 1992 Sep;14(52):44-9.
Standard for assessing the efficacy of screening programs are at present well-established. Nevertheless, the effectiveness of screening programs can reduced by several factors in real world conditions. The aim of this work is to check the feasibility of an operational model for the practical evaluation of the effectiveness of screening programs. In this model seven critical points are defined (recruitment, screening test sensitivity, access to diagnostic services, diagnosis, compliance to follow-up, treatment compliance, therapy) and their contribution to the reduction of potential effectiveness is calculated. For each point consequent problem(s) and possible solutions are predefined. The model was tested with the results of the screening program for amblyopia of the Community Health Service of USL 32 Treviglio (BG) assuming 40% and 97% sensitivity of the screening test. For this screening the reduction of effectiveness at the seven critical points ranged from 0 to 60%, with a total reduction of effectiveness to 15.6-37.8%. The operational model was used to identify causes of this reduction. This kind of analysis is proposed as a tool for evaluation and improvement of the effectiveness of efficacious screening program.
目前，评估筛查项目效果的标准已确立完善。然而，在现实世界条件下，筛查项目的有效性可能会受到多种因素的影响而降低。本研究的目的是检验一种操作模型在实际评估筛查项目有效性方面的可行性。在该模型中，定义了七个关键点（招募、筛查测试敏感性、诊断服务可及性、诊断、随访依从性、治疗依从性、治疗），并计算了它们对潜在有效性降低的影响。针对每个关键点，预先定义了相应的问题及可能的解决方案。该模型采用了意大利布雷西亚省特雷维廖市第32地方卫生单位社区卫生服务中心弱视筛查项目的结果进行测试，假设筛查测试的敏感性分别为40%和97%。对于此次筛查，七个关键点的有效性降低幅度在0至60%之间，总体有效性降低至15.6 - 37.8%。该操作模型用于确定有效性降低的原因。这种分析方法被提议作为评估和提高有效筛查项目有效性的一种工具。
