General introduction 17 1 Healthcare related tests can be used for several purposes: screening, surveillance, risk classification, diagnosis, staging, treatment triage, determination of prognosis and monitoring/follow-up [44, 45]. Examples of these purposes are shown in table 1. A single test can serve multiple purposes, such as an MRI for women with increased risk or suspected of, or diagnosed breast cancer. It can be used for screening, risk classification, diagnosis, staging, and monitoring/follow-up. Table 1. Testing purpose and examples Testing purposes Examples Screening Faecal occult blood testing in people aged 55-75 years to screen for colorectal cancer Anoscopy in people with HIV to screen for anal intraepithelial neoplasia to reduce the risk of anal cancer-related mortality Hip examination in youth care to select infants at high risk of having hip dysplasia Surveillance Influenza surveillance to gain insight in the spread and typology of influenza viruses, and their impact Antimicrobial surveillance to understand antibiotic resistance patterns Risk classification Measurement of blood cholesterol levels and blood pressure in primary care patients to stratify the risk of a cardiovascular event Bone mineral density measurement using DEXA scanning to determine the risk of an osteoporotic fracture Diagnosis Urine dipstick to diagnose urinary tract infection in primary care Amniocentesis including chromosomal testing to rule out trisomy 21 (Down’s syndrome) X-ray to diagnose bone fracture Vision test to detect visual impairment Staging Histology to stage cancer disease CT scanning in patients with breast cancer to detect metastases Beck Depression Inventory to assess level of depression Treatment triage Allergen testing in patients with asthma to guide asthma management Bacteriological test to guide antibiotic treatment Prognosis 6-minute walk distance test (6MWD) to estimate risk of death in patients with heart failure Advanced Dementia Prognostic Tool (ADEPT) to estimate survival in people with dementia Monitoring/ follow-up Blood glucose monitoring to monitor diabetes mellitus Weight measurement to monitor weight loss therapy Spirometry to monitor COPD Cardiac ultrasound to follow-up patients with heart failure As illustrated in table 1, there is a variety of tests, including self-tests, laboratory tests, imaging, functional tests, and questionnaires, as well as a variety of settings in which testing can be performed, such as public health, primary care, secondary care and long-term care.
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