Screening Programs

Neurologic screening asks a population-level question: which people without recognized symptoms need a closer look? It is not a diagnosis, and a test is not automatically useful because it is available. A sound program links an acceptable screen to timely confirmation and an intervention that can improve outcomes; without that pathway, false positives can cause anxiety, unnecessary imaging or procedures, and labeling without benefit. Neurologic practice also uses bedside safety screens. After a stroke, a swallow screen protects the airway before food, fluid, or medication; it does not diagnose the cause of the stroke. FAST identifies a possible stroke and triggers 9-1-1, but it does not determine whether the event is ischemic or hemorrhagic. US recommendations are not interchangeable. The USPSTF finds evidence insufficient for routine cognitive screening in asymptomatic adults 65 years or older, recommends against screening asymptomatic adults for carotid artery stenosis, and has an insufficient-evidence statement for universal autism screening in children 18–30 months without concerns. The AAP, however, recommends autism-specific screening at 18 and 24 months and developmental surveillance at every well-child visit. The population, purpose,...