Zusammenfassung
Screeninguntersuchungen können ein sehr wertvolles Mittel zur Vorbeugung oder wirksameren Bekämpfung von Erkrankungen sein. Dazu müssen eine Reihe von Voraussetzungen erfüllt sein: Die Erkrankung oder eine Krankheitsvorstufe muss bereits in einer präklinischen Phase diagnostizierbar sein, wofür ein geeigneter Test verfügbar sein muss. Die frühere Entdeckung muss dazu führen, dass die Krankheit wirksamer bekämpft werden kann und nicht nur die „Patientenkarriere“ verlängert. Der Nutzen des Screenings muss potenzielle Nachteile überschreiten, zu denen z. B. Komplikationen, falsch positive Diagnosen oder Überdiagnosen (d. h. die Diagnose klinisch irrelevanter Erkrankungsformen) gehören. Der Nutzen muss zu vertretbaren Kosten erreichbar sein. Die Durchführung muss auf der Basis wissenschaftlicher Evidenz erfolgen und wissenschaftlich begleitet werden.
Abstract
Screening can be a very powerful tool for prevention or more effective treatment of diseases. However, a number of prerequisites have to be met. Only diseases with a preclinical phase, during which the disease or its precursors can be detected by a suited test, are amenable to screening. Early detection of the disease must enable either prevention or more effective management of the disease and not just prolong the “patient career”. The benefits of screening must encompass potential harms, which may include, for example, complications, false positive diagnoses or over-diagnoses (i.e. the diagnosis of clinically irrelevant disease). Benefits from screening must be achieved at acceptable costs. Implementation of screening has to be based on scientific evidence and accompanied by scientific evaluation.
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Hoffmeister, M., Haug, U. & Brenner, H. Welche Voraussetzungen sind für ein Screening notwendig?. Internist 49, 655–659 (2008). https://doi.org/10.1007/s00108-008-2127-7
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DOI: https://doi.org/10.1007/s00108-008-2127-7