Assessment Tools and Diagnostic Tests in Adults and Children

For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values.

Include the following:

• A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
  • What is its purpose?
  • How is it conducted?
  • What information does it gather?
• Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

Include the introduction with the purpose statement and conclusion.

Use a heading for each major part of the assignment:

• • What is its purpose?
  • How is it conducted?
  • What information does it gather?
  • Validity and Reliability
  • Issues with Sensitivity, Reliability, and Predictive values

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Solution

Cancer constitutes various types of illness that may start or affect any body tissue or organ following the uncontrollable growth of abnormal cells and invade adjacent tissues when they grow beyond their normal boundaries. This invasion to adjacent cells, organs, or tissues is termed metastasis and is a major cause of mortality among cancer patients. Cancers may also be regarded as malignant tumors or neoplasms. Cancer is ranked the second leading cause of mortality globally, causing approximately 9.5 million deaths (Ilic et al., 2018). Early and accurate assessment and diagnosis can improve the proposed therapy effectiveness and avoid the disease’s long-term complications to the infected individual (Carroll & Mohler, 2018). Various diagnostic and assessment techniques are available for children and adult patients, including screening programs, radical surgery, chemotherapy, radiation, and imaging. This paper will discuss Prostate-Specific Antigen (PSA) as one of the diagnostic tests in male adults.

Purpose of the Test

PSA constitutes a protein produced primarily by the prostate gland cells, both malignant and normal. The PSA test is one blood test that measures the PSA’s levels in a man’s circulating blood. The blood sample is withdrawn, and the results are reported following a laboratory analysis. The findings are reported in nanograms of the protein (PSA) per milliliter (ng/ml) (Fenton et al., 2018). prostate cancer is one of the common cancers in men, besides being a frequent cause of demise in the affected males. Early detection and diagnosis of health issues are vital in initiating appropriate and timely treatment, hence better patient prognosis.

Prostate cancer causes an elevation in the body’s PSA levels. However, other non-cancerous or non-malignant conditions contribute to an increase in this protein level in the body, including bacterial prostatitis, ejaculation, or acute urinary retention. The PSA test’s purpose is to detect the levels of the protein PSA in a men’s body but does not solely provide precise and reliable diagnostic information regarding any underlying pathology (Fenton et al., 2018). The test is significantly implicated in most laboratory settings to detect an elevation of these PSA proteins in the blood. This diagnostic technique is used alongside digital rectal examination.

According to Ilic et al. (2018), combining these assessment and diagnostic tests helps diagnose prostate cancer in male adults. During the digital rectal examination, the physician could press, feel, and detect the size of the patient’s prostate gland, any present hard regions, or abnormal lumps. These two tests do not compressively and entirely diagnose prostate cancer in men. However, abnormal findings in the initial assessment may necessitate a prostate biopsy to determine the presence or absence of malignant prostate cells.  The PSA test may also be implicated in patients already diagnosed with prostate cancer to determine the effectiveness of therapy or check the recurrence of the disease.

How PSA Test is Conducted, and the Information Gathered

The PSA test procedure involves a lab technician or a physician withdrawing a small blood sample from the individual’s upper extremities. The sample is thus sent to the lab to test or detect for the presence of PSA, a specific protein marker that significantly determines the individual’s prostate health (Duffy, 2020).

The prostate-specific antigen test could produce false-positive or false-negative findings. As such, the lab results could indicate exceedingly low or high levels of the protein marker, which may often fail to correlate to prostate cancer’s presence. However, coupling with digital rectal examination and prostate biopsy, prostate cancer detection, and appropriate diagnosis may thus be made.

Various variations in prostate-specific antigen tests have been implicated in clinical settings. For instance, the PSA velocity determines the changes in PSA levels in the individual’s body over time (Nordström et al., 2018). Detection in a rapid rise in this protein often indicates an aggressive form of prostate cancer. The percentage of free prostate-specific antigen is another variation in the diagnosis of prostate cancer. The PSA naturally exists in two forms in circulating blood; unattached or attached to specific blood proteins. High prostate-specific antigen levels with a correspondingly low value in its unattached form likely indicate prostate cancer (Nordström et al., 2018).

Validity and Reliability

The concern of wasteful biopsies, on the one hand, and the greater danger of missing a treatable malignancy, on the other, motivate the need for a precise marker. There is no agreement on which PSA adjustments should be used, and none of them has been proved to minimize the number of needless biopsies or enhance clinical results (Carroll & Mohler, 2018). In some instances, PSA may miss the detection of prostate cancer and provide false reassurance to the individual. Besides, the test does not determine the difference between fast-growing and slow-growing malignancies (Ilic et al., 2018).

Issues with Sensitivity and Predictive values

Ongoing research is to find new blood markers with improved predictive value for prostate cancer, especially those that can anticipate aggressive tumors that can be treated to save lives. A PSA threshold of 4.0 ng/mL was shown to have a sensitivity of 21% for identifying asymptomatic prostate cancer and 51% for fully extended tumors. These sensitivities were raised by 32 and 68 percent, respectively, when a 3.0 ng/mL threshold was used (Fenton et al., 2018). The predictive values for a PSA threshold of 4 and 3 ng/mL were 91 percent and 85 percent, respectively.

Conclusion

In combination with other assessment tests, the PSA test constitutes a major clinically relevant diagnostic test for prostate cancer in men. The test is essentially useful when performed early in individuals at higher of developing this type of cancer. Early detection and diagnosis of prostate cancer enhance the individual’s health outcomes when medical interventions are also simultaneously initiated. Regular screening for this type of cancer facilitates this early detection, minimizing the risk of metastasis and other associated health complications.

References

Carroll, P. H., & Mohler, J. L. (2018). NCCN guidelines updates: prostate cancer and prostate cancer early detection. Journal of the National Comprehensive Cancer Network, 16(5S), 620-623.

Duffy, M. J. (2020). Biomarkers for prostate cancer: prostate-specific antigen and beyond. Clinical Chemistry and Laboratory Medicine (CCLM), 58(3), 326-339.

Fenton, J. J., Weyrich, M. S., Durbin, S., Liu, Y., Bang, H., & Melnikow, J. (2018). Prostate-specific antigen-based screening for prostate cancer: evidence report and systematic review for the US Preventive Services Task Force. Jama, 319(18), 1914-1931.

Ilic, D., Djulbegovic, M., Jung, J. H., Hwang, E. C., Zhou, Q., Cleves, A., … & Dahm, P. (2018). Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. Bmj, 362.

Nordström, T., Akre, O., Aly, M., Grönberg, H., & Eklund, M. (2018). Prostate-specific antigen (PSA) density in the diagnostic algorithm of prostate cancer. Prostate Cancer and Prostatic Diseases, 21(1), 57-63.