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How to use this guide
The Wellness Promotion Programme is designed pre-setup packages
suitable for every individual based on (age cohorts and gender)
tailored to specific needs.
According to Wilson and Jungner in 1968 "The central idea of early disease detection and treatment is essentially simple. However, the path to its successful achievement (bringing to treatment those with previously undetected disease and, avoiding harm to those persons not in need of treatment) is not simple though sometimes it may appear easy."
For this reason, Wilson and Jungner attempted to define screening criteria to guide the selection of conditions that would be suitable for screening, based on the capacity to detect the condition at an early stage and the availability of an acceptable treatment (box 1).
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Box 1. Wilson and Jungner classic screening criteria
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- The condition sought should be an important health problem.
- There should be an accepted treatment for patients with recognized disease.
- Facilities for diagnosis and treatment should be available.
- There should be a recognizable latent or early symptomatic stage.
- There should be a suitable test or examination.
- The test should be acceptable to the population.
- The natural history of the condition, including development from latent to declared disease, should be adequately understood.
- There should be an agreed policy on whom to treat as patients.
- The cost of case-finding (including diagnosis and treatment of patients diagnosed) should be economically balanced in relation to possible expenditure on medical care as a whole.
- Case-finding should be a continuing process and not a “once and for all” project.
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The Wilson and Jungner criteria have long been considered the gold standard in making such decisions. However, several adaptations have been made to the classic criteria, and several new criteria have also emerged (Box 2) with broader trends that have shaped both Western medicine and society more generally over the past generation (e.g. increased consumerism, the shift away from paternalism towards informed choice, a focus on evidence-based health care, and the rise of managed care models that emphasize cost-effectiveness, quality assurance, and accountability of decision-makers).
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Box 2. Synthesis of emerging screening criteria proposed over the past 40 years
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- The screening programme should respond to a recognized need.
- The objectives of screening should be defined at the outset.
- There should be a defined target population.
- There should be scientific evidence of screening programme effectiveness.
- The programme should integrate education, testing, clinical services and programme management.
- There should be quality assurance, with mechanisms to minimize potential risks of screening.
- The programme should ensure informed choice, confidentiality and respect for autonomy.
- The programme should promote equity and access to screening for the entire target population.
- Programme evaluation should be planned from the outset.
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Based on the above we developed the Wellness Promotion Protocols for different age cohorts and gender
A review of screening criteria over the past 40 years (Wilson and Jungner)
Bull World Health Organ vol.86 no.4 Genebra Apr. 2008
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