Assessment Tools and Diagnostic Tests in Adults and Children

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.Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.Photo Credit: Getty Images/Hero ImagesFor 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. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.To PrepareReview this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.Consider how you could encourage parents or caregivers to be proactive toward the child’s health.BELOW IS THE QUESTION———————————————Assignment (3 pages, not including title and reference pages):Assignment Option 1: Adult Assessment Tools or Diagnostic Tests: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.BELOW IS THE REQUIRED READING————————-Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Chapter 3, “Examination 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.Chapter 8, “Growth and Nutrition”In this chapter, the authors explain examinations for growth, gestational age, and pubertal development. The authors also differentiate growth among the organ systems.Chapter 5, “Recording Information” (Previously read in Week 1)This chapter provides rationale and methods for maintaining clear and accurate records. The text also explores the legal aspects of patient records.Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Student checklist: Health history guide. In Seidel’s guide to physical examination (9th ed.). St. Louis, MO: Elsevier Mosby.Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.Centers for Disease Control and Prevention. (2021, April 9). Childhood overweight & obesity. http://www.cdc.gov/obesity/childhood/This website provides information about overweight and obese children. Additionally, the website provides basic facts about obesity and strategies to counteracting obesity.Chaudhry, M. A. I., & Nisar, A. (2017). Escalating health care cost due to unnecessary diagnostic testing. Mehran University Research Journal of Engineering and Technology, (3), 569.This study explores the escalating healthcare cost due the unnecessary use of diagnostic testing. Consider the impact of health insurance coverage in each state and how nursing professionals must be cognizant when ordering diagnostics for different individuals.Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.Chapter 1, “Clinical Reasoning, 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.Noble, H., & Smith, J. (2015) Issues of validity and reliability in qualitative research . Evidence Based Nursing, 18(2), pp. 34-35.Nyante, S. J., Benefield, T. S., Kuzmiak, C. M., Earnhardt, K., Pritchard, M., & Henderson, L. M. (2021). Population‐level impact of coronavirus disease 2019 on breast cancer screening and diagnostic procedures. Cancer, 127(12), 2111-2121. https://doi.org/10.1002/cncr.33460Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). History subjective data checklist. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.Credit Line: Mosby’s Guide to Physical Examination, 7th Edition by Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2011 by Elsevier. Reprinted by permission of Elsevier via the Copyright Clearance Center.This History Subjective Data Checklist was published as a companion to Seidel’s Guide to Physical Examination (8th ed.) by Ball, J. W., Dains, J. E., & Flynn, J.A. Copyright Elsevier (2015). From https://evolve.elsevier.comSullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Week 1)Chapter 5, “Pediatric Preventative Care Visits” (pp. 91 101)THE DIAGNOSTIC TEST WOULD BE Colonoscopy. Please make sure to go into details in explaining it and make sure to add 5 references not more than 5 years old . Please be sure to use APA format 7th edition.This paper must include a title page, introduction, and summary with appropriate citations.Please make sure to use headings to indicate the part of the question you are answering and make sure to go through the rubric CORE SKILL: understanding that a test result is not a fact — it is a probability revision. This assignment is really a course in test characteristics.
THE FOUR NUMBERS, and what each actually means:
— SENSITIVITY: of the people WITH the disease, what fraction does the test correctly identify? A highly sensitive test has few false negatives, so a NEGATIVE result is good for RULING OUT (SnNOut).
— SPECIFICITY: of the people WITHOUT the disease, what fraction does the test correctly clear? A highly specific test has few false positives, so a POSITIVE result is good for RULING IN (SpPin).
— POSITIVE PREDICTIVE VALUE: given a positive test, what is the probability the patient actually HAS the disease?
— NEGATIVE PREDICTIVE VALUE: given a negative test, what is the probability they don’t?
THE INSIGHT THAT SEPARATES A STRONG PAPER FROM A WEAK ONE: sensitivity and specificity are properties OF THE TEST and are (roughly) stable across populations. PPV AND NPV DEPEND ON PREVALENCE. Screen a low-prevalence population and even an excellent test generates mostly FALSE POSITIVES — this is the mathematics behind mass-screening controversies and it is not intuitive. Work one example numerically: a test with 99% sensitivity and 99% specificity applied to a disease with 0.1% prevalence yields a PPV of roughly 9% — over 90% of positives are false. Show that calculation and you have demonstrated the whole point of the assignment.
RELIABILITY vs. VALIDITY — do not conflate them: RELIABILITY is consistency (test-retest, inter-rater — measured by kappa, internal consistency by Cronbach’s alpha). VALIDITY is accuracy (content, construct, criterion). A test can be perfectly reliable and completely invalid — a consistently miscalibrated scale. Reliability is NECESSARY BUT NOT SUFFICIENT for validity.
ALSO KNOW: likelihood ratios (more useful clinically than PPV/NPV because prevalence-independent), ROC curves and AUC, and the sensitivity/specificity TRADE-OFF as you move the cut-point — which is a VALUES decision, not a statistical one (you accept more false positives when missing the disease is catastrophic).
FACTORS AFFECTING VALIDITY IN PRACTICE: population differences (a tool validated on white adults may perform differently in other groups — pulse oximetry OVERESTIMATES oxygen saturation in patients with darker skin, a well-documented and clinically consequential example worth citing), age (pediatric vs. adult norms), language and literacy of the instrument, spectrum bias, and verification bias.
FOR THE CASE: pick your tools, state their sensitivity/specificity WITH A CITATION, justify why they suit THIS patient’s age/risk/presentation, and — the part that earns the top band — address what a false positive or false negative would COST this specific patient.

Expert Help With This Assignment — On Your Terms