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Wright CF, Zimmern RL. Conceptual issues for screening in the genomic era - time for an update?. Epidemiol Biostat Public Health. 2014;11(4)doi: 10.2427/9944.
Wright, C. F., & Zimmern, R. L. (2014). Conceptual issues for screening in the genomic era - time for an update?. Epidemiology, biostatistics and public health, 11(4), . https://doi.org/10.2427/9944
Wright, Caroline F, and Zimmern, Ron L. "Conceptual issues for screening in the genomic era - time for an update?." Epidemiology, biostatistics and public health vol. 11,4 (2014). doi: https://doi.org/10.2427/9944
Wright CF, Zimmern RL. Conceptual issues for screening in the genomic era - time for an update?. Epidemiol Biostat Public Health. 2014 Dec 11;11(4). doi: 10.2427/9944. PMID: 26973821; PMCID: PMC4783824.
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Epidemiol Biostat Public Health. 2014 Dec 11;11(4). doi: 10.2427/9944.

Conceptual issues for screening in the genomic era - time for an update?.

Epidemiology, biostatistics and public health

Caroline F Wright, Ron L Zimmern

Affiliations

  1. Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge UK.
  2. PHG Foundation, Cambridge UK.

PMID: 26973821 PMCID: PMC4783824 DOI: 10.2427/9944

Abstract

BACKGROUND: Screening tests are ubiquitous in modern medicine; however a consensus view on the criteria that distinguish screening from clinical testing remains strangely elusive. although numerous definitions of screening have been suggested, there is considerable variation amongst them, leading to confusion and disagreement amongst clinicians and public health professionals alike. In light of developments in genomics, the question of what screening entails is becoming increasingly pressing.

METHODS: We evaluated the concepts underlying definitions of screening versus clinical testing and investigated their ethical implications.

RESULTS: We suggest that just two key concepts underlie screening: first, screening tests are performed in

CONCLUSIONS: We emphasise the need to differentiate between opportunistic screening and clinical testing because of the differing prior probability of disease and thus the differing ethical burden of responsibility placed upon the physician in each scenario. Physicians need to appreciate the shifting moral burden placed upon them in relation to reactive clinical testing versus proactive screening, and the different legal obligations that may ensue.

Keywords: clinical tests; genomic era; screening tests

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