Assignment: NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children
Walden University Assignment: NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children-Step-By-Step Guide
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After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for Assignment: NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children
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How to Write the Body for Assignment: NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children
After the introduction, move into the main part of the Assignment: NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for Assignment: NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for Assignment: NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.
Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.
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For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.
To Prepare
Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.
Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
Consider how you could encourage parents or caregivers to be proactive toward the child’s health.
The Assignment
Assignment (3–4 pages, not including title and reference pages):
Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
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Include the following:
A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
What is its purpose?
How is it conducted?
What information does it gather?
Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.
Assignment Option 2: Child Health Case:
Include the following:
An explanation of the health issues and risks that are relevant to the child you were assigned.
Describe additional information you would need in order to further assess his or her weight-related health.
Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.
Sample Answer for Assignment NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children
Child Health Case
The rising prevalence of obesity in children has become a major concern in healthcare. According to statistics, the prevalence of obesity in children 2-5 years is 12.7% and 20.7% in children aged between 6 and 11 years (CDC, 2022). Obesity puts children at risk of poor health outcomes in childhood and adulthood. According to Sanyaolu et al. (2019), children who are obese are likely to remain that way even in adulthood, putting them at risk of developing chronic conditions including stroke, type 2 diabetes, heart disease, and cancer, among other top ten leading causes of death in America. Hence, monitoring a child’s weight is essential in preventing potential obesity. In most cases, obesity is due to lifestyle and living conditions. In the chosen case study, an overweight five-year-old child has parents who are overweight and working all the time, which reveals a great deal of information regarding the child’s socioeconomic circumstances and risk factors for poor health outcomes. The purpose of this paper is to evaluate the boy’s case and identify the risk factors he is exposed to owing to his surroundings and family lifestyle.
Health Issues and Risks
The child is overweight, which is of great concern because it puts the child at risk of obesity. Obesity is a risk factor for multiple conditions that impact a child’s functioning, growth and development, and overall well-being. Children with overweight and obesity issues are likely to develop sleep disorders, type 2 diabetes, asthma, heart disease, high blood pressure, gallstones, liver problems and early puberty. In addition, being overweight or obese can also lead to low social competence in children. The likelihood of overweight or obese children being bullied is 63% greater than other children (Sanyaolu et al., 2019). Bullying has sociopsychological effects on children, including isolation, low self-esteem, poor body image, depression, suicide, and anxiety. In the case study, the child is only five years old, and experiences of bullying and its sociopsychological implications can negatively impact his growth and development.
Additionally, the boy’s weight indicates that he is not eating healthy foods and snacks physical activity. Indulging in high sugar content and processed foods more than healthy choices leads to being overweight. Since the parents are working almost all the time, they do not have time to prepare proper meals; hence rely on first food and soft drinks for meals. A lack of healthy meal options means that the boy does not get enough nutritional nutrients that he needs at his stage for proper growth and development (Dains et al., 2019). This puts him at risk of deficiencies and poor health outcomes because of low immunity that cannot sufficiently fight off pathogens causing diseases. For example, he can be susceptible to infections. Moreover, both parents are overweight, which points to the possibility of the overweight being a genetic issue. Nevertheless, whether genetic or not, being overweight puts the patient at risk of obesity and other health issues.
Additional Information
The child’s background suggests that he comes from a low socioeconomic background. Therefore, additional information would be focused on evaluating the child’s social determinants of health and other issues that impact weight. For example, information about the child’s eating habits and availability of basic needs, including healthy meal choices. This information will help to know what the child’s nutrition is like and whether it is the cause of his overweight. Additionally, information on the child’s physical activity will also be an essential part of the assessment (Srinath et al., 2019). For example, asking the child if they enjoy playing out with friends or if he spends most of his time in the house watching television and playing video games. If the child is living a sedentary lifestyle without engaging in physical play, it can contribute to their overweight. The living conditions also can impact the child’s health; for example, if they live in a place with a playing field or have no space for playing, it discourages physical activity while encouraging a sedentary lifestyle (Smith et al. 2020).
Health Risks
The child’s well-being and health are at stake because of being overweight. The first health risk is obesity. I would collect information by measuring the child’s weight and height and then calculating the BMI. Secondly, the child is at risk of developing one or more chronic conditions such as diabetes or heart problems. I would assess this information by asking about the child’s health, including recent hospitalizations, if any. The child may also be at risk of psychosocial development because being overweight affects interaction with peers. Hence, it does not give the child opportunity for proper psychosocial development. Further information would be collected by asking the parents about the child’s social life, interaction with other children, and emotional displays that might point to a problem (Ball et al., 2019).
The physical growth and development of the child are also a concern. For example, according to the development theories, at age five, a child is physically active and should demonstrate better coordination and balance. The boy’s low socioeconomic status is a risk factor for poor health outcomes; for example, unsafe and congested living conditions can lead to injury and infections (Ball et al., 2019). Further information would be gathered by asking about the child’s socioeconomic background. While doing the assessment and health interview, it is essential to observe confidentiality, privacy, and respect for the patient’s culture.
Specific Questions
Does your child have any health issues?
What kinds of meals do you prepare at home?
Do you earn enough to support the family’s needs, particularly the essential needs?
Where do you live?
How many people live in your household?
Does your child like to play and interact with other children?
Strategies for Promoting Healthy Weights
I will use the Health Promotion Model (HPM) to educate the parents and caregivers on the dangers of being overweight and the benefits of maintaining a healthy weight (Narzisi & Simons, 2021). Secondly, I would educate the parents on proper nutrition and suggest foods they can include in their child’s diet, such as plenty of fruits and vegetables, more grains, and less fast-food and processed foods. The parents will also be encouraged to limit snacks and substitute unhealthy snacks with healthy choices such as nuts. Another strategy is to educate the parents on the importance of physical education. If the parents adopt physical activity in their lifestyle, it will influence the child also to become more physically active and lose weight.
Conclusion
Statistics show that childhood obesity is rising, putting more children at risk of poor health outcomes. The child in this case study is a five-year-old boy who is overweight. Both parents are also overweight, and he spends time with his grandmother, as the parents are busy working. The child is at risk of developing obesity, which would make him susceptible to chronic conditions including diabetes, heart disease, kidney problems, and cancer. The boy presumably lives in a low-socioeconomic neighbourhood, further exposing him to negative health outcomes. To mitigate potential negative health risks, the parents must adjust the boy’s diet to incorporate foods with more nutritional value and avoid processed foods and soft drinks. Additionally, the family need lifestyle adjustment to adopt physical activity to help them maintain healthy weights.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
CDC. (2022, May 17). Childhood Obesity Facts: Prevalence of Childhood Obesity in the United States. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/obesity/data/childhood.html#:~:text=Prevalence%20of%20Childhood%20Obesity%20in%20the%20United%20States&text=The%20prevalence%20of%20obesity%20was,to%2019%2Dyear%2Dolds.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Narzisi, K., & Simons, J. (2021). Interventions that prevent or reduce obesity in children from birth to five years of age: A systematic review. Journal of Child Health Care, 25(2), 320–334. https://doi.org/10.1177/1367493520917863.
Sanyaolu, A., Okorie, C., Qi, X., Locke, J., & Rehman, S. (2019). Childhood and Adolescent Obesity in the United States: A Public Health Concern. Global Pediatric Health, https://doi.org/10.1177/2333794X19891305.
Smith, J. D., Fu, E., & Kobayashi, M. A. (2020). Prevention and Management of Childhood Obesity and Its Psychological and Health Comorbidities. Annual review of clinical psychology, 16, 351–378. https://doi.org/10.1146/annurev-clinpsy-100219-060201.
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical Practice Guidelines for Assessment of Children and Adolescents. Indian journal of psychiatry, 61(Suppl 2), 158–175. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18.
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Sample Answer 2 for Assignment NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children
One of the most prevalent chronic diseases in the US continues to be obesity. The high incidence of obesity continues to pressure the American healthcare system since it significantly contributes to death, morbidity, disability, healthcare utilization, and costs (Anderson et al., 2019). Anthropometric measures and information gathering on a client’s medical history, clinical and biochemical characteristics, dietary habits, current treatments, and food security situation are all included in nutrition assessment. Nutritional status is the body’s state concerning each nutrient and its overall weight and condition, and it plays a significant role in promoting health and preventing and treating disorders.
Rapid and easy identification of individuals who may be malnourished or at risk of malnutrition and require a more thorough nutrition evaluation can be done before a complete nutrition assessment. Checking for bilateral pitting edema, evaluating weight and mid-upper arm circumference (MUAC), and asking about recent illnesses and hunger are all simple nutrition screening techniques. Standardized training is needed for nutrition screening per local and national health regulations. The paper highlights health issues identified in a 5 – year old overweight black boy with overweight parents that are full-time employees.
Relevant Health Issues and Risks
Preschoolers of color (ages 2–5) have slightly higher rates of obesity than white children. Black children, however, have greater obesity prevalence rates by age 6. Lifestyle choices like nutrition, activity level, culture, environment, and parental judgments are all connected to obesity in preschoolers (Anderson et al., 2019). Issues identified in the 5- year -old boy are age, race, family history of obesity, full-time parental employment, and grandparent’s care. A myriad of health issues, including diabetes, heart disease, sleep apnea, stress, anxiety, depression, low self-esteem, eating disorders, hypertension, stroke, asthma, cancer, breathing problems, bone, and joint disorders, gall bladder disease, infertility, eating disorders, dyslipidemia, liver problems, high cholesterol, and sleep issues are all at risk for patients with childhood obesity.
In many high-income countries, paid work has increased in two-parent and lone-parent families during the past few decades. These changes are primarily the result of more mothers entering the workforce. It has been proposed that parental employment, specifically maternal employment, is a risk factor for childhood obesity. Lack of adequate leisure outside of work has been cited as a major mechanism for a relationship between employment and childhood overweight (Fryar et al., 2018). Due to time constraints, it may be challenging to promote a healthy lifestyle, including a balanced diet and regular mealtimes, encouraging kids to participate in physical activity, limiting their screen time, and having kids walk to school rather than be driven.
Grandparents can have a significant impact on the growth and development of their grandchildren. Parent-child care is associated with a 30% greater incidence of childhood obesity and overweight (Sadruddin et al., 2019). Some believe that “the bigger, the healthier” is still valid. Some grandparents could view a child’s larger weight as a sign of health. As a result, some kids are advised to eat larger portions and more frequently. Some grandparents may give children candy and fried foods as a gesture of love and goodwill. In some cultures, grandparents may even be more willing to excuse kids from completing duties around the house, which is a crucial exercise.
Gathering Further Information
A comprehensive history is vital in the patient’s evaluation. The Pediatric Obesity Algorithm is an evidence-based guide for diagnosing and treating obese children (Fryar et al., 2018). A healthcare provider should gain further information on the diet, activity level, family social history, including the parent’s working hours, birth and developmental history, and parental perceptions of obesity, and screen for any obesity-related complications. Because controlling these behaviors is essential to the success of any weight-management program, it is important to rule out the possibility of food-seeking behavior, bingeing, lack of satiety, purging, night-eating syndrome, and other abnormal feeding patterns.
For diet inventory, the healthcare provider should utilize the 24 – hour recall, food group, and food frequency questionnaire. The history of the breast- or bottle-feeding, the timing of the introduction of complementary foods, parenting techniques, cultural expectations, screen time, mealtime locations, bullying or social exclusion, the family’s willingness and capacity to make changes, and finally, financial constraints are all part of the family and social history. A child’s activity level should also be evaluated, along with the child’s access to secure exercise places and any necessary support for high activity levels. The practitioner must also evaluate non-academic screen time and sedentary time.
Questions posed to the parents and child include: Kindly give me a 24-hour recall of the foods you have taken. How often do you prepare homemade food? What is the estimated time you have with your child outside work? Kindly explain your house plan. What are some of the exercises and play activities that your child takes part in? Can you name some of your child’s friends? Has your child reported bullying or isolation by friends at any time? Do you give the grandmother any instructions on feeding and exercise of the child? Are there other obese family members? Do you think that your child has a weight problem? What are some of the risks the child may suffer from being overweight? What measures have you taken to deal with the issue?
Encouraging Active Parents’ Involvement
Parents serve as powerful role models for children aged 5 to 9 years, so it is highly advised that the family be involved in the care of the child who is obese. There should be a strict limit on non-academic screen time overall (Chai et al., 2019). A reduction in obesity is linked to substituting moderately intense physical activity for screen time. Children in this age range still need between 11 and 14 hours of sleep, preferably all at once, and naps cannot accomplish this during the day due to deficiencies at night. Sleep is still essential. The recommended daily caloric intake for obese children aged 5 to 9 is three meals and one or two wholesome snacks. Three servings of protein, 1-2 servings of dairy, and 4-5 servings of non-starchy vegetables should be consumed daily from each food group. They should not consume any fast food or beverages with added sugar. Children should be encouraged to try different meals, and portion amounts should be age-appropriate.
The parents should be actively involved by reading materials regarding the management of obesity. They may join hands and form support groups with parents dealing with the same issue. A nutrition plan and exercise should be developed in consultation with the nutritionist. The parents should also lose weight to serve as role models to their children in the weight management journey. The grandmother should be informed of the measures so that she can implement them when with the child. The parents should be encouraged to seek more secure jobs that ensure that either parent is available, especially after school. The patient should be encouraged that it is a gradual process that needs patience and consistency.
Conclusion
Childhood obesity is a chronic condition that can cause early comorbidity, mortality, and physical and psychological consequences. Lifestyle choices like nutrition, activity level, culture, environment, and parental judgments are all connected to obesity in preschoolers. Promoting healthy behaviors could help eliminate health disparities and enhance the quality of life. Programs should target young Black children and their families to lower the incidence of obesity. To prevent childhood obesity and overweight, nurses must offer comprehensive, culturally relevant strategies at the community, individual, and family levels.
References
Anderson, P. M., Butcher, K. F., & Schanzenbach, D. W. (2019). Understanding recent trends in childhood obesity in the United States. Economics & Human Biology, 34, 16-25. https://doi.org/10.1016/j.ehb.2019.02.002
Chai, L. K., Collins, C., May, C., Brain, K., Wong See, D., & Burrows, T. (2019). Effectiveness of family-based weight management interventions for children with overweight and obesity: an umbrella review: An umbrella review. JBI Database of Systematic Reviews and Implementation Reports, 17(7), 1341–1427. https://doi.org/10.11124/JBISRIR-2017-003695
Fryar, C. D., Carroll, M. D., & Ogden, C. L. (2018). Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2–19 years: United States, 1963–1965 through 2015–2016. https://stacks.cdc.gov/view/cdc/58669
Sadruddin, A. F., Ponguta, L. A., Zonderman, A. L., Wiley, K. S., Grimshaw, A., & Panter-Brick, C. (2019). How do grandparents influence child health and development? A systematic review. Social Science & Medicine, 239, 112476. https://doi.org/10.1016/j.socscimed.2019.112476
Sample Answer 3 for Assignment NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children
Introduction
Colorectal cancer, often known as colon cancer, is the third most common cancer in men and women. Fortunately, it is detectable and preventable with early screening approaches that may begin as early as age 45. To identify abnormalities in the colon, colonoscopy is the recommended form of colon cancer screening, a sort of imaging examination. The procedure is carried out by introducing a camera-equipped flexible tube into the anus and rectum. Cologuard, a less invasive and more convenient alternative to colonoscopy, has gained popularity. Cologuard’s usage has increased in popularity due to the COVID-19 epidemic, owing to its ease of administration. While the Cologuard screening has some advantages, it also has some disadvantages. A significant worry is its inaccuracy, making it not a substitute for a colonoscopy. This paper will cover the goal of the Cologuard test, how it is administered, the data obtained, and the test’s validity and reliability, among others.
Description of how Cologuard is used in Healthcare
Cologuard is a rectal and colon cancer screening test. Each day, the colon loses cells from its lining. These cells move through the colon with the excrement. Specific genes in cancer cells may have undergone mutations. Cologuard is capable of detecting the changed DNA. The presence of abnormal cells or blood in faces may suggest the presence of cancer or precancerous tumors. Cologuard is designed to identify DNA markers associated with colorectal neoplasia and detect occult hemoglobin in human faces. A positive result might suggest the presence of colorectal cancer (CRC) or advanced adenoma and should be followed up with a diagnostic colonoscopy (Ned et al., 2011). Cologuard may be used by those with 45 years and above also having an average risk of getting colorectal cancer. Cologuard is not a substitute for colonoscopy monitoring or diagnostic colonoscopy in high-risk people. Colon cancer may be detected with Cologuard since the colon’s lining releases cells daily. These cells eventually end up in the feaces. The feaces may also include abnormal cells from a malignant tumor or precancerous polyp and blood from any ruptured blood vessels. Polyps are benign growths on the surface of the colon that have the potential to develop into cancer.
Cologuard’s instructions are straightforward, and the screening process is completed in a matter of minutes. The test should be completed within five days after obtaining the kit. After obtaining the kit, begin by removing all materials except those required for the sample. The sample of the stool should not exceed the size of the liquid bottle contained in the package. Attempting to avoid getting pee on the sample is critical. This may be accomplished by emptying the bladder first and avoiding contaminating the faces sample with toilet paper or other things. The sample should be obtained when a person knows he or she can return the sample within a day of collection (Ned et al., 2011). After that, the huge sample container is inserted into the toilet bracket using the included instructions. A fecal sample must be taken using the large sample container when one is on the toilet. It is important to remove a sample container from the toilet mount after collecting it, then set it on a flat surface. Place the scraped sample in a small test tube. Before labeling and sealing the tiny and big sample containers, apply the preservative to the larger container. Before delivering the sample to the lab, be sure to follow the included packing instructions to the letter. Cologuard is a stool test that detects DNA and hemoglobin (blood) produced by these aberrant cells.
Validity and Reliability Cologuard Test
Cologuard is a test intended to identify cancer, not prevent it (JAMA , 2014). Cologuard detects just 42% of big polyps, while a colonoscopy detects 95% of large polyps. When polyps are discovered during a colonoscopy, they are simultaneously removed. If polyps are found using Cologuard, they must be removed by colonoscopy. Cologuard cannot identify the majority of big precancerous polyps. This may give patients the erroneous impression that they avoid colon cancer by getting the Cologuard test. In a nutshell, there is no genuine substitute for a colonoscopy. Due to its astounding success rate in diagnosing colorectal cancer early on, the illness has become one of the most preventable types of cancer (Imperiale et al., 2014). While alternative tests, such as Cologuard, are available and may have some advantages, such as little preparation and invasiveness, the findings are less trustworthy. Individuals with abnormal results will still need a colonoscopy for confirmation.
Cologuard testing has several downsides, most notably accuracy, particularly when compared to a colonoscopy. Cologuard has an overall sensitivity of 95.2 percent for colon cancer (Exact Sciences, 2022). Additional studies revealed a sensitivity of 57.2 percent for all advanced precancerous lesions and 83.3 percent for high-grade dysplasia. Colonoscopy detects precancerous lesions and polyps more accurately than stool sample testing, according to Li (2018). Physicians prefer to send patients for colonoscopies rather than a stool test since false positives are more common. The major purpose of screening tests is to rule out illnesses like cancer; therefore, sensitivity is a critical consideration. Imperiale et al. (2014) argue that with an 87 percent overall specificity, the DNA test’s sensitivity for advanced precancerous lesions was half that of colorectal cancer.
References
Exact Sciences, (2022). Exact Sciences presents data showing improved accuracy of second-generation Cologuard® test and progress toward an even better colorectal cancer screening solution for patients. https://www.exactsciences.com/newsroom/exact-sciences-presents-data-showing-improved-accuracy-of-second-generation-cologuard-test
Imperiale, T. F., Ransohoff, D. F., Itzkowitz, S. H., Levin, T. R., Lavin, P., Lidgard, G. P., Ahlquist, D. A., & Berger, B. M. (2014). Multitarget stool DNA testing for colorectal-cancer screening. New England Journal of Medicine, 370(14), 1287–1297.
Li, D. (2018). Recent advances in colorectal cancer screening. Chronic Diseases and Translational Medicine, 4(03), 139–147.
Ned, R. M., Melillo, S., & Marrone, M. (2011). Fecal DNA testing for colorectal cancer screening: The ColoSureTM test. PLoS Currents, 3.
A Stool DNA Test (Cologuard) for Colorectal Cancer Screening. (2014). JAMA: The Journal of the American Medical Association, 312(23), 2566. https://doi.org/10.1001/jama.2014.15746
Sample Answer 4 for Assignment NURS 6512 Assessment Tools and Diagnostic Tests in Adults and Children
The assessment tools help in the diagnosis of various health conditions. A good tool should have a high level of accuracy and reliability. The burden of breast cancer continues to increase in the current era and so better and accurate tools need to be developed to increase the screening and diagnostic accuracy. The current study explores the effectiveness of mammogram tests in detecting breast cancer.
The Purpose of the Test
A mammogram is an x-ray of the breast. The test is done to screen for breast cancer. The imaging technique uses a low x-ray dose to produce a pictorial presentation of the breast. Women are encouraged to have the test done regularly to help in the early detection of breast cancer considering that cancer is among the leading killer diseases in women (Seely & Alhassan, 2018). Late diagnosis results in poor prognosis since the cancerous cells spread to other parts of the body and so become difficult to treat. The mammogram aims to help in identifying the changes in the breast tissue. The test can detect micro-calcifications of less than 100 micrometers; therefore, it can detect the possibility of a patient having cancer before even the palpable lumps form. Furthermore, the test involves one or two views of the breast tissues and so provides an accurate visualization of the breast. Alternatively, the test is also done in symptomatic cases to help in the pre-surgical localization.
Conducting the Test
Patient preparation is important for obtaining the most accurate results from the imaging technique. The patients are expected not to wear talcum powders because they can produce calcium artefacts that will result in false-positive results. The patient must reveal any underlying condition they could be having. Also, the radiologist should let their patients understand the implication of the test and what they expect to minimize anxiety. The prepared patients are then asked to stand in front of the x-ray machine with their breasts put on a plastic plate. The plate is pressed firmly on the breast to flatten them and allow penetration of the x-ray (Mack & Lapane, 2019). Furthermore, the flattening is meant to achieve an even thickness and improve the sensitivity of the test procedure in identifying the abnormalities in the brain. X-rays can be harmful to health; therefore, it is recommended to use low-dose x-ray. The scattering of the rays must be prevented so that they don’t reach other parts of the body and this is achieved through the compression of the breasts (Le & Adler, 2020).
Alternatively, a digital mammogram may also be taken using a full-field digital electron system. The images captured from the radiological analysis are transferred to the computer. Digitalization improves the accuracy of the diagnostic procedure because it minimizes human errors. Tomosynthesis is 3-D mammography that produces many images of the breast from different angles. The variations in the calcium distribution and tissue densities are identified from the image and used to make a diagnosis.
Gathered Information
The test provides information on the mass distribution of the breast, the availability of lumps, and areas of calcification. The tiny calcium deposits in the breast cannot be detected by palpating, therefore, the tests identify the micro-calcifications in the breast tissue (Iranmakani et al., 2020).
Validity, Sensitivity, and Reliability of Mammography Sensitivity
A good test should have the ability to detect the true positives and true negatives. On the other hand, the sensitivity and specificity of the tests are affected by various factors. Therefore, there will always be cases of false positive or false negative. The mammogram test is reliable and valid because it provides comprehensive imaging of the breast and so helps in identifying even the micro-calcifications (Badu-Peprah & Adu-Sarkodie, 2018). In addition, the test is also standardized and this reduces the variability in the results reporting. Digital mammograms are more accurate and reliable. According to Giampietro et al. (2020), the estimated sensitivity value for the breast mammogram is 87% which is significantly high. On the other hand, about 7% of the true cases are usually negative. However, the issues of false positives can be addressed by having multiple images taken so that only those people with breast cancer are reported to be having the disease. On the other hand, most of the false-positive cases are reported among the patients undergoing hormonal therapy because the procedure increases the breast densities and this could be confused for cancer. The positive predictive value and the negative predictive value for a mammogram are 89% and 90.9% respectively (Giampietro et al., 2020). The high predictive value indicates that the test is reliable.
Conclusion
Finally, a reliable test should produce a consistent result and this is an element of predictive value or reproducibility. Mammogram has a high predictive value and so valid and reliable test for screening and diagnosis of breast cancer. Furthermore, the test has a low level of false-positive cases reported.
References
Giampietro, R. R., Cabral, M. V., Lima, S. A., Weber, S. A., & Dos Santos Nunes-Nogueira, V. (2020). Accuracy and effectiveness of mammography versus mammography and Tomosynthesis for population-based breast cancer screening: A systematic review and meta-analysis. Scientific Reports, 10(1). https://doi.org/10.1038/s41598-020-64802-x
Seely, J., & Alhassan, T. (2018). Screening for breast cancer in 2018—What should we be doing today? Current Oncology, 25(11), 115-124. https://doi.org/10.3747/co.25.3770
Le, T. T., & Adler, F. R. (2020). Is mammography screening beneficial: An individual-based stochastic model for breast cancer incidence and mortality. https://doi.org/10.1101/2020.01.30.20019596
Mack, D. S., & Lapane, K. L. (2019). Screening mammography among older women: A review of United States guidelines and potential harms. Journal of Women’s Health, 28(6), 820-826. https://doi.org/10.1089/jwh.2018.6992
Badu-Peprah, A., & Adu-Sarkodie, Y. (2018). Accuracy of clinical diagnosis, mammography, and ultrasonography in preoperative assessment of breast cancer. Ghana Medical Journal, 52(4), 235. https://doi.org/10.4314/gmj.v52i4.11
Iranmakani, S., Mortezazadeh, T., Sajadian, F., Ghaziani, M. F., Ghafari, A., Khezerloo, D., & Musa, A. E. (2020). A review of various modalities in breast imaging: Technical aspects and clinical outcomes. Egyptian Journal of Radiology and Nuclear Medicine, 51(1). https://doi.org/10.1186/s43055-020-00175-5