[揽瓜阁精读] 131.screening test

tizo

131。 screening
1. 介绍一类人，总想提前知道自己哪里有病
2. 引出主题，screening就是这样一种工具手段
3. 一种提前查病的理念的发展加速了测试工具的传播
4. 这种测试理念有个问题，没啥用。screening查出来以后没法组织，你也做不了什么
5. Screening会出现两种错误。negative：得病了但没显示出来positive：  没得病但显示得病了，举个例子说明positive更严重，因为制造出的错误更多
6. 提出弥补错误的一些方法，多次测试。

iii886

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无所思思

i

3316

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iii886

1、一种能预测疾病的test
2、它在预防精神疾病上的功劳
3、但也不是一定useful。比如很多时候查出来了也不知道咋治
4、还容易出现错误：1、有病没查出来 2、查出来的病不存在

强调了提前查明疾病的重要性。引出Screening
用sluggsih thyroids和phenylketonuria这种先天的化学错误为例。讲如果这种病如果快速查出来，就能治好；如果不治疗，就会导致精神延迟。
看似这个例子认为这个具体知识可以发明一种能预先阻止疾病而不是缓和或修复疾病的药——无病神药。然后说这种screen可以让很多看似很健康的人被查出来问题。
然而，也不是想的那么好。这个知识并不是一直有用的。比如screening暴露了些问题，想做点啥治病却不知道做点啥。治疗预先的疾病并不比治疗疾病容易多少。你能知道什么不等于你能做什么。
然后除了上面那个问题，还说了screening两种错误信息：1false negative 2 false positive然后通过一组数据说明第二个错误往往更是问题。因为它误判的人数更多。
热衷于screening的人尝试排除这点并且去推动screening策略让敏感度比特异性更高。比如，更频繁地重复screening，就能让那些含糊不清的案例被筛出来。后面的具体做法没咋看懂，但是会有95个倒霉蛋被无缘无故测两次。总之就是说了能排出这俩错误的办法，多测几次。

pin down v. 发现，查明；确定；使受约束；阻止；迫使（某人）明确表态
ail vt. 使苦恼，使烦 vi. 生病 n. 病痛，苦恼
retardation：延迟
holdout：坚持
forestall：先发制人、预先阻止
hasten：催促、加快
pinpoint：vt. 查明；精确地找到；准确描述 adj. 精确的；详尽的 n. 针尖；精确位置
boarderline：adj含糊不清的，临界情况的

Hazellto

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lastchance2010

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Morgen_

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lastchance2010

Content
P1: 不想吃没有被测试过的药的人却很乐意去做没有价值的医疗测试。他们会后悔这个结果。
Their number is increasing. Their faith and that of their doctors – better to find out what gets you sick in the future and deal with it. The day to be judged with ailment may never come.
P2: It sounds sensible and has worked in cases. (this indicates that there will be a “but” or “however”). Screening newborns for thyroids and an inborn chemical error is the only example:  promptly detected, these disturbances can be counteracted; untreated, they cause retardation. Core sentence- screening has saved millions of people from getting retarded.
P3: The newborn example supports medicine without illness, spreading the practice of using tools to proactively pinpoint problems of the sick people to screen healthy people. The stream of genetic information is likely to hasten that spread.  
Evidence: The newborn example supports the promise of a new type of medicine to forestall disease rather than mitigate or reverse it.
P4: However, test results sometimes are not helpful.
     Evidence: find a problem, but don’t know what to do about it. Screening tests are easier to invent than treatments, mismatch between results and what to do about it is likely to continue to increase.
P5: As well as … 顺着上面说testing 的缺点。Screening tests also produce false information: false negative – 有病但是结果显示没病；false positive -没病但是结果显示有病。 Sensitivity high – false negative low; Specificity high, false positive number high?. When screening for a condition few people have, false positive > false negative.
P6: Screening enthusiasts tend to dismiss this point (-false result), and they push for screening -high sensitivity > specificity as priorities – repeat tests frequently. Conclusion – repeating the tests does not help.
Structure
作者提出一个现象，并表明态度-negative.
               解释现象合理和现象产生的原因
•        Evidence: testing newborns and acting accordingly saves millions of people
•        Such examples led to the spread of the practice of medical testing
作者观点: testing 不好
Evidence:
1.        Result is not helpful – may find out why and can’t fix it
2.        Results provides false information – cannot be resolved with repeated testing

Attitude
作者是持反对态度。先是提出问题，先表扬再提出作者反对的原因。（直接上来就批评太不友好了，哈哈）

carmen26

谢谢！！！！！！！