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Mediational screening: is the benefit worth the cost?
1Department of Psychology, Michigan State University, East Lansing 48824.
American Journal of Community Psychology
|December 1, 1991
Summary
Mediational screening may offer limited benefits and incur significant costs. Researchers advocate for universal interventions due to the difficulty in predicting who will develop conditions after life stress.
Area of Science:
- Psychology
- Public Health
- Intervention Science
Background:
- Mediational screening aims to identify individuals at risk for negative outcomes.
- Pillow et al. (1991) proposed benefits including increased statistical power, cost-effectiveness, and reduced iatrogenic effects.
Purpose of the Study:
- To critically evaluate the benefits and costs of mediational screening.
- To reassess the utility of mediational screening in light of potential misclassification costs.
Main Methods:
- Cost-benefit analysis of mediational screening.
- Review and critique of proposed benefits (statistical power, cost-effectiveness, iatrogenic effects).
- Consideration of costs associated with false positives and false negatives.
Main Results:
- The suggested benefits of mediational screening (statistical power, cost-effectiveness, reduced iatrogenic effects) are likely modest.
- Costs stemming from misclassification (false positives/negatives) significantly impact the overall cost-benefit analysis.
- Inaccurate prediction of individual responses to life stress complicates targeted prevention.
Conclusions:
- Mediational screening's advantages may be overestimated, while its costs are underestimated.
- Universal interventions are recommended due to the challenges in predicting individual vulnerability to stress-related conditions.
- A re-evaluation of screening procedures is necessary for effective public health and prevention strategies.