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Open Access 01-01-2018 | Controversies in Pediatric Nephrology
Why should we screen for arterial hypertension in children and adolescents?
Published in: Pediatric Nephrology | Issue 1/2018
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Screening is a strategy used in a given population to identify an unrecognized disease in otherwise healthy people without any signs or symptoms. This can include individuals with pre-symptomatic or unrecognized symptomatic disease. As such, screening tests are somewhat unique in that they are performed on persons apparently in good health. The aim of screening is to diagnose disease at its earliest, preclinical stage and, if possible, to initiate treatment or lifestyle intervention before irreversible complications develop. However, screening may lead to overdiagnosis, and may occasionally result in adverse effects caused by unnecessary diagnostic tests, false diagnosis and even unnecessary treatment. On the other hand, screening tests with low sensitivity may create a false sense of security and, therefore, they must be characterized by both good sensitivity and specificity. In 1968 the World Health Organization published guidelines on the “Principles and practice of screening for disease”. Although these principles were modified in 2008 and adjusted to screening based on genomic technologies, the main principles of screening, known as Wilson’s criteria, are still valid (Table 1) [1].
Table 1
World Health Organization screening criteria
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World Health Organization screening criteriaa
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1. The condition should be an important health problem.
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2. There should be a treatment for the condition.
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3. Facilities for diagnosis and treatment should be available.
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4. There should be a latent stage of the disease.
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5. There should be a test or examination for the condition.
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6. The test should be acceptable to the population.
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7. The natural history of the disease should be adequately understood.
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8. There should be an agreed policy on whom to treat.
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9. The total cost of finding a case should be economically balanced in relation to medical expenditure as a whole.
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10. Case-finding should be a continuous process, not just a “once and for all” project
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