When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.
In this Discussion, 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.
To prepare:
Review this week’s Learning Resources, and consider the factors that impact the validity and reliability of various assessment tools and diagnostic tests.
Select one of the following assessment tools or diagnostic tests to explore for the purposes of this Discussion:
Mammogram
Physical tests for sore throat (inspecting the throat, palpating the head and neck lymph nodes, listening to breath sounds)
Prostate-specific antigen (PSA) test
Dix-Hallpike test
Body-mass index (BMI) using waist circumference for adults
Search the Walden Library and credible sources for resources explaining the tool or test you selected. What is its purpose, how is it conducted, and what information does it gather?
Examine the literature and resources you located for information about the validity and reliability of the test or tool you selected. What issues with sensitivity, specificity, and predictive values are related to the test or tool?
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Are there any controversies or issues related to any of these tests or tools?
Consider any ethical dilemmas that could arise by using these tests or tools.
Question:
Discuss a description of how the assessment tool or diagnostic test you selected is used in health care. 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.
Readings
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 2, œCultural Awareness
This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.
Chapter 3, œExamination Techniques and Equipment
This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2012). Advanced health assessment and clinical diagnosis in primary care (4th ed.). St. Louis, MO: Mosby, Elsevier.
Chapter 1, œClinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis
This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw Hill Medical.
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Chapter 3, œThe Physical Screening Examination
In this chapter, the authors describe methods for physical examination and procedures for screening physical examinations. In addition, this chapter explains the necessary preparations and equipment for conducting exams.
Chapter 17, œPrinciples of Diagnostic Testing
The authors use this chapter to discuss the principles of diagnostic testing. The chapter specifies tools that may be used in the selection and interpretation of tests.
Chapter 18, œCommon Laboratory Tests
This chapter details normal and pathologic results for common tests of the blood, urine, cerebrospinal fluid, and serous fluid. Additionally, this chapter describes reasons for ordering different types of lab tests.
Laine, C. (2012). High-value testing begins with a few simple questions. Annals of Internal Medicine, 156(2), 162“163.
Retrieved from the Walden Library databases.
This article supplies a list of questions physicians should ask themselves before ordering tests. The authors provide general guidelines for maximizing the value received from testing.
Qaseem, A., Alguire, P., Dallas, P., Feinberg, L. E., Fitzgerald, F. T., Horwitch, C., & ¦ Weinberger, S. (2012). Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care. Annals of Internal Medicine, 156(2), 147“149.
Retrieved from the Walden Library databases.
This article highlights the increasing cost of health care and stresses the need for high-value and cost-conscious testing. The authors provide a list of 37 situations in which more testing provides no benefit or may be harmful.
Shaw, S. J., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2009). The role of culture in health literacy and chronic disease screening and management. Journal of Immigrant & Minority Health, 11(6), 460“467.
Retrieved from the Walden Library databases.
This article examines cultural influences on health literacy, cancer screening, and chronic disease outcomes. The authors postulate that cultural beliefs about health and illness affect a patient’s ability to comprehend and follow a health care provider’s instructions.
Wians, F. H. (2009). Clinical laboratory tests: Which, why, and what do the results mean? LabMedicine, 40, 105“113.
Retrieved from http://labmed.ascpjournals.org/content/40/2/105.full
