Screening Wilson's criteria

See also Screening.

Wilson's criteria are derived from a World Health Organisation monograph published by Wilson and Jungner in 1968.^[1][2] The monograph is very readable, demonstrating clarity and practicality of thought. It well deserves to have withstood the test of time (as it has), and to remain one of the all-time classical texts of modern medicine. The criteria have been modified (see screening for details) but are still basically sound.

Contents 1 The problem 2 The screening population 3 The test and the treatment 4 The programme 5 References

The problem

• Is the disease an important health problem? (Common, such as breast cancer; rare but serious and treatable such as phenylketonuria).
• Is there a recognisable latent or early symptomatic stage? The natural history of the disease must be known.

The screening population

• Can the population that needs treating be clearly defined, and called for screening?

The test and the treatment

Are facilities for diagnosis and treatment available?

• Diagnostic test must be suitable:
  • affordable (ideally cheap, easy to perform, widely available)
  • acceptable to patient
  • specific
  • sensitive
  • reliable (repeatable, good inter-operator agreement)
  • good positive and negative predictive values
  • subject to quality assurance

• Treatment must be suitable:
  • affordable
  • effective
  • acceptable to patient
  • subject to quality assurance

• Is there an agreed policy on whom to treat as patients?

• Does treatment confer benefit?

The programme

Has the cost of the programme been considered in the context of other demands for resources?

Overall programme must be:

• • affordable (opportunity cost must be considered)
  • worthwhile
  • auditable
  • subject to quality assurance

References