Simple Screening Instruments for Chronic Disease & Personalised Prevention at the Workplace

Abstract

Prevention refers to actions directed to preventing illness and promoting health. It includes the assessment of disease risk and early diagnosis. Preventive strategies are most commonly classified based on the level of selection being applied in the target group or the stage in the disease process where preventive measures are employed. The entire population is aimed at in universal prevention whereas other prevention strategies target specific groups in the general population. In selective prevention, individuals at high risk are identified through the presence of specific risk factors, such as smoking, age, and lack of physical activity. Indicated prevention is aimed at identifying individuals with minimal but detectable signs or symptoms e.g. high blood pressure and high cholesterol, but who are not diagnosed as having the disease of interest. Categorising by disease progression, primary prevention seeks to prevent the onset of disease by risk reduction in the community, whereas secondary prevention includes procedures that detect and treat pre-clinical pathological changes and thereby control disease progression. Once a disease has developed and has been treated in its acute clinical phase, tertiary prevention seeks to soften the impact caused by the disease on the patient’s function, longevity, and quality of life. In this thesis we focus on screening, which is part of secondary preventive interventions and includes determining disease risk in apparently healthy individuals as well as detection of those at early stages of a disease or condition.1;2 When used as a selective prevention strategy, screening is often a first step in controlling disease progression, as it selects individuals for early interventions and/or additional testing.