A diagnostic test has been introduced that will detect a ceain disease 1 year earlier than it is usually detected. Which of the following is most likely to happen to the disease within 10 years after the test is introduced? (Assumed that early detection has no effect on the natural history of the disease. Also assume that no changes in death ceification practises occur during the 10 years.)
Correct Answer: The apparent 5-year survival rate will increase
Description: Survival rate: Survival rate calculation SR= Total number of patients alive after 5 years/ Total number of diagnosed or treated x 100 Survival rate is complement of Case fatality rate (CFR) : SR = 1- CFR. Whenever screening is performed: Higher 5-year survival rate is observed. THIS IS A POTENTIAL BIAS DUE TO earlier diagnosis being made (and not because people live longer) In the given question, a diagnostic test has been introduced that will detect a ceain disease 1 year ealier than it is usually detected. Thus, the incidence rate (new cases) will remain same after 10 years. And it will also have no effect on age adjusted moality rate. But, since disease is getting detected 1 year earlier than usual (LEAD TIME), treatment can be staed 1 year earlier (CFR will be apparently lowered), thus leading to apparent increase in survival rate. Ref: Epidemiology by Leon Gordis 4th edition Pgno: 97 Park 24th edition PGno: 69-70
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