Screening and diagnostic tests are evaluated to

Screening and diagnostic tests are evaluated to determine how reliable and valid they are. A reliable test gives the same results when it is repeated. A valid test is one that accurately measures what it is supposed to measure (LaMorte, 2016a). A weight scale that repeatedly measures an adult’s weight as 12.6 lbs. is reliable but not valid. Screening and diagnostic tests must be reliable. Whether a screening or diagnostic test is valid may be determined by calculating the sensitivity and specificity of the test. Sensitivity refers to how well the test identifies whether the test-taker has the condition being measured (LaMorte, 2016a). Specificity refers to how well the test identifies whether the test-taker does not have the condition being measured. Highly sensitive tests identify more people who might have a condition. They result in more false-positive but few false-negative test results. Highly specific tests identify more people who do not likely have the condition. They result in more false-negative but few false-positive test results. The ideal screening or diagnostic test has a sensitivity of 100% and a specificity of 100%. In practice, no test is that accurate. Clinicians select screening tests that are low cost, easy to use, do not cause discomfort, and can be completed quickly (LaMorte, 2016b). Screening tests should have greater sensitivity. Diagnostic tests are used to confirm that a test-taker who screened positive has the condition being measured. They should have greater specificity. Nurses must be able to assess the level of anxiety among clients, families, and healthcare team members (Halter, 2019). They need to be aware of their own anxiety level and have well-developed ways to reduce their anxiety to care for others. The client experiencing a health crisis or coping with a chronic disease exacerbation is likely to have a moderate level of anxiety. There are two versions of a tool used to assess for generalized anxiety disorder (GAD). The first is a 7-item test, the GAD-7. The second was developed and tested using just 2 of the 7 items, the GAD-2 (Plummer et al., 2016). The GAD-7 results in a total score from 0 (no anxiety) to a score of 21 (severe anxiety). Based on numerous studies, a total score ≥8 indicates the presence of generalized anxiety. Researchers identified the sensitivity and specificity of the GAD-7 and the GAD-2. They also compared the validity of the GAD-7 to a gold standard test, the criteria for GAD according to the DSM-5. Plummer et al. (2016) found sensitivity for the GAD-7 with the cutoff point of a total score ≥8 was 83% and specificity was 84%. The GAD-2, using just the first two items on the GAD-7 and the cutoff point of a total score ≥3, had a sensitivity of 76% and a specificity of 81%. Image transcription text Generalized Anxiety Disorder 7- item (GAD-7) Over the last 2 weeks, how often have you been bothered by Not at Several More tha… Show more 1) Clinicians cannot change any wording or formatting of a standardized questionnaire. However, identify one of the GAD-7 items that you think might not accurately measure generalized anxiety disorder for clients with limited English proficiency. Explain why. 2)Clinicians cannot change any wording or formatting of a standardized questionnaire. However, identify one of the GAD-7 items that you think might not accurately measure generalized anxiety disorder for clients for clients from diverse cultures and socioeconomic backgrounds. Explain why. 3)Based on your evaluation of your anxiety, in general, and/or your GAD-7 score, identify two strategies you will use this semester to reduce your level of anxiety.

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