{"id":6261,"date":"2026-05-27T21:19:10","date_gmt":"2026-05-28T01:19:10","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&#038;p=6261"},"modified":"2026-06-04T22:07:05","modified_gmt":"2026-06-05T02:07:05","slug":"introduction-to-diagnostic-testing","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/introduction-to-diagnostic-testing\/","title":{"raw":"Section 5 Introduction to Diagnostic Testing","rendered":"Section 5 Introduction to Diagnostic Testing"},"content":{"raw":"<h3><span style=\"color: #1f5c99\"><strong>The Range of Diagnostic Tests<\/strong><\/span><\/h3>\r\nA wide variety of tests provide clues toward diagnosis, for example:\r\n<ul>\r\n \t<li><strong>Chemistry tests:<\/strong>\u00a0 Assess components of <strong>blood, urine, CSF<\/strong> (cerebrospinal fluid) and <strong>stool<\/strong> (e.g., lipids, pH, O<sub>2<\/sub> levels, and presence of certain enzymes, normal\/abnormal proteins, antibodies, waste products).<\/li>\r\n \t<li><strong>DNA tests:<\/strong>\u00a0 Determine genetic risk factors, diagnose genetic disorders, verify transplant donor-recipient compatibility, and detect presence of specific microbial infections.<\/li>\r\n \t<li><strong>Pressure tests:<\/strong>\u00a0 Measure blood pressure, heart contraction pressure, intracranial pressure, and ocular pressure.<\/li>\r\n \t<li><strong>Volume tests: <\/strong> Measure functional lung volumes (e.g., spirometry)<\/li>\r\n \t<li><strong>Palpation tests:<\/strong>\u00a0 Assess heart and pulse rates.<\/li>\r\n \t<li><strong>Microscopy tests: <\/strong> Analyze cellular features within biopsies, detect and identify pathogens (e.g., throat swabs, fecal analysis), and<span class=\"transcription-time-part\" style=\"text-align: initial;font-size: 1em\" data-time-start=\"1291.04\" data-time-end=\"1294.549\"> analyze for other abnormalities (e.g. crystals or protein casts in urine).<\/span><\/li>\r\n \t<li><strong>Listening tests (auscultation): <\/strong> Evaluate breath, heart, and bowel sounds.<\/li>\r\n \t<li><strong>Flow cytometry: <\/strong> Count WBCs and RBCs per mL of blood.<\/li>\r\n \t<li><strong>Nerve conduction tests: <\/strong> Assess nerve damage through sensory and motor neuron function tests.<\/li>\r\n \t<li><strong>Imaging:<\/strong>\r\n<ul>\r\n \t<li>X-ray (radio-dense structures like bone),<\/li>\r\n \t<li>CT scans (3D x-ray), MRI (soft tissues),<\/li>\r\n \t<li>Ultrasound (heart valve movement, fetal development),<\/li>\r\n \t<li>ECG, electrocardiogram (cardiac conduction),<\/li>\r\n \t<li>EEG, electroencephalogram (brain electrical activity), and<\/li>\r\n \t<li>EMG electromyogram (skeletal muscle function, ability of muscle to contract when electrically stimulated).<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Endoscopy: <\/strong> A camera on a flexible tube inserted into the body to view suspected areas of damage.<\/li>\r\n \t<li><strong>Biopsy followed by histology:<\/strong>\u00a0 Microscopic analysis of tissue samples for changes in cellular morphology.<\/li>\r\n<\/ul>\r\n[caption id=\"attachment_3464\" align=\"alignnone\" width=\"300\"]<a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Spirometry_NIH-2.jpeg\" target=\"_blank\" rel=\"noopener\"><img class=\"wp-image-3464 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Spirometry_NIH-2-300x260.jpeg\" alt=\"An illustration depicting an incentive spirometer.\" width=\"300\" height=\"260\" \/><\/a> Spirometry is the most common type of pulmonary function test. he patient takes a deep breath and blows as hard as possible into a tube connected to a spirometer. The incentive spirometer measures the amount of air breathed out. It also measures how fast the air was blown out.[\/caption]\r\n\r\n[caption id=\"attachment_2257\" align=\"alignnone\" width=\"191\"]<a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_EEG_6199_-_Smart-Servier.png\" target=\"_blank\" rel=\"noopener\"><img class=\"wp-image-2257 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_EEG_6199_-_Smart-Servier-191x300.png\" alt=\"Diagram of an electroencephalogram (EEG)\" width=\"191\" height=\"300\" \/><\/a> Electroencephalography (EEG) is a test that measures the electrical activity of the brain. Electrodes are attached to the scalp to record electrical impulses of brain cells.[\/caption]\r\n\r\n[caption id=\"attachment_2266\" align=\"alignnone\" width=\"256\"]<a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Parasagittal_MRI_of_human_head_in_patient_with_benign_familial_macrocephaly_prior_to_brain_injury_ANIMATED.gif\" target=\"_blank\" rel=\"noopener\"><img class=\"wp-image-2266 size-full\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Parasagittal_MRI_of_human_head_in_patient_with_benign_familial_macrocephaly_prior_to_brain_injury_ANIMATED.gif\" alt=\"An animated MRI image of the human head. Magnetic resonance imaging (MRI) is a test that uses magnetic forces and radiofrequency waves to create detailed three-dimensional images of internal structures in the body, including organs, bones, and tissues.\" width=\"256\" height=\"256\" \/><\/a> An animated MRI image of the human head. Magnetic resonance imaging (MRI) is a test that uses magnetic forces and radiofrequency waves to create detailed three-dimensional images of internal structures in the body, including organs, bones, and tissues.[\/caption]\r\n\r\n[caption id=\"attachment_2269\" align=\"alignnone\" width=\"300\"]<a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_Endoscopy_-_Smart-Servier.png\" target=\"_blank\" rel=\"noopener\"><img class=\"wp-image-2269 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_Endoscopy_-_Smart-Servier-300x148.png\" alt=\"An endoscope is a tool used in endoscopy to examine internal bodily structures. Endoscopes are typically thin, hollow tubes with a light on the end. However, endoscopes can be equipped with a small video camera so that the operator can project the video on a computer screen, for example during surgery.\" width=\"300\" height=\"148\" \/><\/a> An endoscope is a tool used in endoscopy to examine internal bodily structures. Endoscopes are typically thin, hollow tubes with a light on the end. However, endoscopes can be equipped with a small video camera so that the operator can project the video on a computer screen, for example during surgery.[\/caption]\r\n<h3><span style=\"color: #1f5c99\"><strong>Normal Ranges, False Positives, and False Negatives<\/strong><\/span><\/h3>\r\nA<strong> bell curve<\/strong> is commonly used to illustrate the normal range of a test result in a given population.\u00a0 Results that fall outside this range may indicate disease and disruption of homeostasis, though it is important to note that abnormal test results do not always indicate disease (and normal results do not guarantee health).\r\n\r\n&nbsp;\r\n\r\n[caption id=\"attachment_374\" align=\"alignnone\" width=\"300\"]<img class=\"wp-image-374 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/t56twotail1198-300x202.png\" alt=\"\" width=\"300\" height=\"202\" \/> Figure:\u00a0 Distribution plot of heart rate of 57 college men. The mean pulse rate was found to be 70.4211 beats per minute (bpm) with a standard deviation of 9.9480 bpm.[\/caption]\r\n\r\nIn the above figure, a typical <strong>bell curve<\/strong> indicates the range of test results that can be expected in a set population.\u00a0 In this case, <strong>resting heart rate data<\/strong> has been graphed for 57 college males.\u00a0 Even though the low and high ends of the graph have been coloured red, all of the resting heart rates in this particular population ( which are from ~60-80bpm) are in the expected normal range.\u00a0 Typically, if a resting heart rate is below 60bpm or above 100bpm, it would be considered abnormal, and indicative of a disruption in homeostasis.\u00a0 If a disease is suspected, and results fall outside of what is considered normal, usually follow-up and complementary tests are performed in order to gain enough information to make an accurate diagnosis.\r\n<table class=\"grid landscape\" style=\"border-collapse: collapse;width: 100%;height: 60px\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 15px\">\r\n<td class=\"border\" style=\"width: 19.3694%;height: 15px\"><span style=\"color: #032c80\"><strong>True Negative<\/strong><\/span><\/td>\r\n<td style=\"width: 80.6306%;height: 15px\">A healthy person's test results are normal - correctly confirming the absence of disease.<\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px\">\r\n<td class=\"shaded\" style=\"width: 19.3694%;height: 15px\"><span style=\"color: #032c80\"><strong>False Positive<\/strong><\/span><\/td>\r\n<td class=\"shaded\" style=\"width: 80.6306%;height: 15px\">A healthy person's test results are abnormal - incorrectly suggesting disease.<\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px\">\r\n<td class=\"border\" style=\"width: 19.3694%;height: 15px\"><span style=\"color: #032c80\"><strong>True Positive<\/strong><\/span><\/td>\r\n<td style=\"width: 80.6306%;height: 15px\">A sick person's test results are abnormal - correctly identifying disease.<\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px\">\r\n<td class=\"shaded\" style=\"width: 19.3694%;height: 15px\"><span style=\"color: #032c80\"><strong>False Negative<\/strong><\/span><\/td>\r\n<td class=\"shaded\" style=\"width: 80.6306%;height: 15px\">A sick person's test results are normal - failing to detect disease that is present.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\nMost often, complimentary and follow-up tests are used together to build confidence in a diagnosis, since no single test is 100% accurate.\r\n<table class=\"grid landscape\" style=\"border-collapse: collapse;width: 100%;height: 30px\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 15px\">\r\n<td class=\"border\" style=\"width: 13.0631%;height: 15px\"><span style=\"color: #032c80\"><strong>Sensitivity<\/strong><\/span><\/td>\r\n<td style=\"width: 86.9369%;height: 15px\"><strong style=\"text-align: initial;font-size: 1em\">Can a test accurately detect True Positives?\u00a0 <\/strong>A sensitive test is positive in the presence of disease.\u00a0 A 99% sensitive test correctly identifies 99 out of 100 sick people.<\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px\">\r\n<td class=\"shaded\" style=\"width: 13.0631%;height: 15px\"><span style=\"color: #032c80\"><strong>Specificity<\/strong><\/span><\/td>\r\n<td class=\"shaded\" style=\"width: 86.9369%;height: 15px\"><strong style=\"text-align: initial;font-size: 1em\">Can a test accurately detect True Negatives?<\/strong>\u00a0 A 99% specific test correctly identifies 99 out of 100 healthy people.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<span style=\"text-align: initial;font-size: 1em\">The typical diagnostic strategy begins with a highly <strong>sensitive<\/strong> test to alert as many people with the disease as possible.\u00a0 A highly <strong>specific<\/strong> test then follows up to identify and reassure healthy individuals who received false positives from the first test.<\/span>\r\n\r\n[caption id=\"attachment_407\" align=\"alignnone\" width=\"300\"]<img class=\"wp-image-407 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/Cervical-Cancer-Screening-300x207.png\" alt=\"\" width=\"300\" height=\"207\" \/> Figure: Management algorithm in primary HPV screening. Abnormal cytology refers to a borderline or more severe cytological result. This figure was adapted from Chrysostomou et al. (2018) [15]. This algorithm was developed based on \u201cThe supplements of the second edition of the European Guidelines for Quality Assurance in Cervical Cancer Screening of 2015\u201d[\/caption]In the above figure, a new added step to the protocol for cervical testing is being developed and implemented in some countries.\u00a0 \u00a0The newly added step is the first one, in which a <strong>Primary HPV<\/strong> (Human Papilloma Virus) test, a highly <strong>sensitive<\/strong> test is used that screens for the DNA presence of the HPV strains that are considered high risk for cancer development.\u00a0 The <strong>cytology test<\/strong> involves the <strong>Pap smear<\/strong> with microscopic analysis of cervical cellular morphology.\u00a0 Traditionally, the cytology (Pap smear) test is used as the initial test, and is also considered highly <strong>sensitive<\/strong> with an even greater degree of <strong>specificity<\/strong> than the HPV test.\u00a0 The third test in the above figure, the <strong>colposcopy<\/strong> test is considered a highly <strong>specific<\/strong> test.\r\n\r\n&nbsp;\r\n\r\n[caption id=\"attachment_426\" align=\"alignnone\" width=\"300\"]<img class=\"wp-image-426 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/PocketColposcope-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" \/> Figure:\u00a0 Pocket Colposcope (2018) Colpscopy is a specificity test performed when abnormal cells are detected in a Pap smear.\u00a0 It involves using a colposcope, a thin flexible tube with lighted, magnifying camera that can examine the cervix, vagina, and vulva for lesions and signs of cancer.[\/caption]\r\n\r\n<div class=\"mceTemp\"><\/div>\r\n\r\n[caption id=\"attachment_427\" align=\"alignnone\" width=\"300\"]<img class=\"wp-image-427 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/05\/images_large_10.1177_11769351231161477-fig1-300x86.jpeg\" alt=\"\" width=\"300\" height=\"86\" \/> Figure: Anatomical view of cervix (a), cross-sectional view of cervix (b).[\/caption]\r\n\r\n[caption id=\"attachment_432\" align=\"alignnone\" width=\"300\"]<img class=\"wp-image-432 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/colposcopy-300x198.png\" alt=\"\" width=\"300\" height=\"198\" \/> Figure: Colposcopy The above figures show the strategy most often used in diagnostic testing, in which the first test used is a highly <strong>Sensitive<\/strong> test, which is very good at identifying illness, and makes sure that you can alert as many people as possible that may have the illness.\u00a0 \u00a0The <strong>Specificity<\/strong> test typically follows the Sensitivity test, and is used to identify false positives (e.g. make sure those that are healthy are correctly identified, and then alerted that they don't have the disease,\u00a0 and are not treated for a disease that they don't have).[\/caption]\r\n<h3><span style=\"color: #1f5c99\"><strong>Ethics of Diagnostic Tests<\/strong><\/span><\/h3>\r\nThe design and use of diagnostic tests raises important ethical questions.\u00a0 Tests are most often developed and used with the following priorities in mind:\r\n<ul>\r\n \t<li>A significant percentage of the population is at risk.<\/li>\r\n \t<li>Test development is feasible.<\/li>\r\n \t<li>The test will be reliable (valid and repeatable).<\/li>\r\n \t<li>The test will be sensitive and\/or specific.<\/li>\r\n \t<li>The test will be inexpensive and affordable.<\/li>\r\n \t<li>The test will be easy to store and deliver.<\/li>\r\n \t<li>The test will be user-friendly and not prone to human error.<\/li>\r\n \t<li>Ideally, the test is <strong>non-invasive<\/strong> (which also reduces cost and time).<\/li>\r\n<\/ul>\r\n<div class=\"textbox textbox--key-takeaways\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\"><strong>Examples of Non-Invasive Tests<\/strong><\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nNon-invasive tests include: blood tests, urinalysis, sputum, and stool sample analysis, x-rays (e.g., mammograms), and physical exams.\r\n\r\n<\/div>\r\n<\/div>\r\n&nbsp;\r\n\r\n[h5p id=\"50\"]\r\n<div class=\"mceTemp\"><\/div>","rendered":"<h3><span style=\"color: #1f5c99\"><strong>The Range of Diagnostic Tests<\/strong><\/span><\/h3>\n<p>A wide variety of tests provide clues toward diagnosis, for example:<\/p>\n<ul>\n<li><strong>Chemistry tests:<\/strong>\u00a0 Assess components of <strong>blood, urine, CSF<\/strong> (cerebrospinal fluid) and <strong>stool<\/strong> (e.g., lipids, pH, O<sub>2<\/sub> levels, and presence of certain enzymes, normal\/abnormal proteins, antibodies, waste products).<\/li>\n<li><strong>DNA tests:<\/strong>\u00a0 Determine genetic risk factors, diagnose genetic disorders, verify transplant donor-recipient compatibility, and detect presence of specific microbial infections.<\/li>\n<li><strong>Pressure tests:<\/strong>\u00a0 Measure blood pressure, heart contraction pressure, intracranial pressure, and ocular pressure.<\/li>\n<li><strong>Volume tests: <\/strong> Measure functional lung volumes (e.g., spirometry)<\/li>\n<li><strong>Palpation tests:<\/strong>\u00a0 Assess heart and pulse rates.<\/li>\n<li><strong>Microscopy tests: <\/strong> Analyze cellular features within biopsies, detect and identify pathogens (e.g., throat swabs, fecal analysis), and<span class=\"transcription-time-part\" style=\"text-align: initial;font-size: 1em\" data-time-start=\"1291.04\" data-time-end=\"1294.549\"> analyze for other abnormalities (e.g. crystals or protein casts in urine).<\/span><\/li>\n<li><strong>Listening tests (auscultation): <\/strong> Evaluate breath, heart, and bowel sounds.<\/li>\n<li><strong>Flow cytometry: <\/strong> Count WBCs and RBCs per mL of blood.<\/li>\n<li><strong>Nerve conduction tests: <\/strong> Assess nerve damage through sensory and motor neuron function tests.<\/li>\n<li><strong>Imaging:<\/strong>\n<ul>\n<li>X-ray (radio-dense structures like bone),<\/li>\n<li>CT scans (3D x-ray), MRI (soft tissues),<\/li>\n<li>Ultrasound (heart valve movement, fetal development),<\/li>\n<li>ECG, electrocardiogram (cardiac conduction),<\/li>\n<li>EEG, electroencephalogram (brain electrical activity), and<\/li>\n<li>EMG electromyogram (skeletal muscle function, ability of muscle to contract when electrically stimulated).<\/li>\n<\/ul>\n<\/li>\n<li><strong>Endoscopy: <\/strong> A camera on a flexible tube inserted into the body to view suspected areas of damage.<\/li>\n<li><strong>Biopsy followed by histology:<\/strong>\u00a0 Microscopic analysis of tissue samples for changes in cellular morphology.<\/li>\n<\/ul>\n<figure id=\"attachment_3464\" aria-describedby=\"caption-attachment-3464\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Spirometry_NIH-2.jpeg\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3464 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Spirometry_NIH-2-300x260.jpeg\" alt=\"An illustration depicting an incentive spirometer.\" width=\"300\" height=\"260\" srcset=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Spirometry_NIH-2-300x260.jpeg 300w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Spirometry_NIH-2-65x56.jpeg 65w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Spirometry_NIH-2-225x195.jpeg 225w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Spirometry_NIH-2-350x304.jpeg 350w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Spirometry_NIH-2.jpeg 475w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-3464\" class=\"wp-caption-text\">Spirometry is the most common type of pulmonary function test. he patient takes a deep breath and blows as hard as possible into a tube connected to a spirometer. The incentive spirometer measures the amount of air breathed out. It also measures how fast the air was blown out.<\/figcaption><\/figure>\n<figure id=\"attachment_2257\" aria-describedby=\"caption-attachment-2257\" style=\"width: 191px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_EEG_6199_-_Smart-Servier.png\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2257 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_EEG_6199_-_Smart-Servier-191x300.png\" alt=\"Diagram of an electroencephalogram (EEG)\" width=\"191\" height=\"300\" srcset=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_EEG_6199_-_Smart-Servier-191x300.png 191w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_EEG_6199_-_Smart-Servier-650x1024.png 650w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_EEG_6199_-_Smart-Servier-768x1209.png 768w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_EEG_6199_-_Smart-Servier-65x102.png 65w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_EEG_6199_-_Smart-Servier-225x354.png 225w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_EEG_6199_-_Smart-Servier-350x551.png 350w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_EEG_6199_-_Smart-Servier.png 956w\" sizes=\"auto, (max-width: 191px) 100vw, 191px\" \/><\/a><figcaption id=\"caption-attachment-2257\" class=\"wp-caption-text\">Electroencephalography (EEG) is a test that measures the electrical activity of the brain. Electrodes are attached to the scalp to record electrical impulses of brain cells.<\/figcaption><\/figure>\n<figure id=\"attachment_2266\" aria-describedby=\"caption-attachment-2266\" style=\"width: 256px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Parasagittal_MRI_of_human_head_in_patient_with_benign_familial_macrocephaly_prior_to_brain_injury_ANIMATED.gif\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2266 size-full\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Parasagittal_MRI_of_human_head_in_patient_with_benign_familial_macrocephaly_prior_to_brain_injury_ANIMATED.gif\" alt=\"An animated MRI image of the human head. Magnetic resonance imaging (MRI) is a test that uses magnetic forces and radiofrequency waves to create detailed three-dimensional images of internal structures in the body, including organs, bones, and tissues.\" width=\"256\" height=\"256\" \/><\/a><figcaption id=\"caption-attachment-2266\" class=\"wp-caption-text\">An animated MRI image of the human head. Magnetic resonance imaging (MRI) is a test that uses magnetic forces and radiofrequency waves to create detailed three-dimensional images of internal structures in the body, including organs, bones, and tissues.<\/figcaption><\/figure>\n<figure id=\"attachment_2269\" aria-describedby=\"caption-attachment-2269\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_Endoscopy_-_Smart-Servier.png\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2269 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_Endoscopy_-_Smart-Servier-300x148.png\" alt=\"An endoscope is a tool used in endoscopy to examine internal bodily structures. Endoscopes are typically thin, hollow tubes with a light on the end. However, endoscopes can be equipped with a small video camera so that the operator can project the video on a computer screen, for example during surgery.\" width=\"300\" height=\"148\" srcset=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_Endoscopy_-_Smart-Servier-300x148.png 300w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_Endoscopy_-_Smart-Servier-768x378.png 768w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_Endoscopy_-_Smart-Servier-65x32.png 65w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_Endoscopy_-_Smart-Servier-225x111.png 225w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_Endoscopy_-_Smart-Servier-350x172.png 350w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2024\/09\/Equipment_-_Endoscopy_-_Smart-Servier.png 896w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-2269\" class=\"wp-caption-text\">An endoscope is a tool used in endoscopy to examine internal bodily structures. Endoscopes are typically thin, hollow tubes with a light on the end. However, endoscopes can be equipped with a small video camera so that the operator can project the video on a computer screen, for example during surgery.<\/figcaption><\/figure>\n<h3><span style=\"color: #1f5c99\"><strong>Normal Ranges, False Positives, and False Negatives<\/strong><\/span><\/h3>\n<p>A<strong> bell curve<\/strong> is commonly used to illustrate the normal range of a test result in a given population.\u00a0 Results that fall outside this range may indicate disease and disruption of homeostasis, though it is important to note that abnormal test results do not always indicate disease (and normal results do not guarantee health).<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_374\" aria-describedby=\"caption-attachment-374\" style=\"width: 300px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-374 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/t56twotail1198-300x202.png\" alt=\"\" width=\"300\" height=\"202\" srcset=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/t56twotail1198-300x202.png 300w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/t56twotail1198-65x44.png 65w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/t56twotail1198-225x151.png 225w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/t56twotail1198-350x236.png 350w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/t56twotail1198.png 578w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-374\" class=\"wp-caption-text\">Figure:\u00a0 Distribution plot of heart rate of 57 college men. The mean pulse rate was found to be 70.4211 beats per minute (bpm) with a standard deviation of 9.9480 bpm.<\/figcaption><\/figure>\n<p>In the above figure, a typical <strong>bell curve<\/strong> indicates the range of test results that can be expected in a set population.\u00a0 In this case, <strong>resting heart rate data<\/strong> has been graphed for 57 college males.\u00a0 Even though the low and high ends of the graph have been coloured red, all of the resting heart rates in this particular population ( which are from ~60-80bpm) are in the expected normal range.\u00a0 Typically, if a resting heart rate is below 60bpm or above 100bpm, it would be considered abnormal, and indicative of a disruption in homeostasis.\u00a0 If a disease is suspected, and results fall outside of what is considered normal, usually follow-up and complementary tests are performed in order to gain enough information to make an accurate diagnosis.<\/p>\n<table class=\"grid landscape\" style=\"border-collapse: collapse;width: 100%;height: 60px\">\n<tbody>\n<tr style=\"height: 15px\">\n<td class=\"border\" style=\"width: 19.3694%;height: 15px\"><span style=\"color: #032c80\"><strong>True Negative<\/strong><\/span><\/td>\n<td style=\"width: 80.6306%;height: 15px\">A healthy person&#8217;s test results are normal &#8211; correctly confirming the absence of disease.<\/td>\n<\/tr>\n<tr style=\"height: 15px\">\n<td class=\"shaded\" style=\"width: 19.3694%;height: 15px\"><span style=\"color: #032c80\"><strong>False Positive<\/strong><\/span><\/td>\n<td class=\"shaded\" style=\"width: 80.6306%;height: 15px\">A healthy person&#8217;s test results are abnormal &#8211; incorrectly suggesting disease.<\/td>\n<\/tr>\n<tr style=\"height: 15px\">\n<td class=\"border\" style=\"width: 19.3694%;height: 15px\"><span style=\"color: #032c80\"><strong>True Positive<\/strong><\/span><\/td>\n<td style=\"width: 80.6306%;height: 15px\">A sick person&#8217;s test results are abnormal &#8211; correctly identifying disease.<\/td>\n<\/tr>\n<tr style=\"height: 15px\">\n<td class=\"shaded\" style=\"width: 19.3694%;height: 15px\"><span style=\"color: #032c80\"><strong>False Negative<\/strong><\/span><\/td>\n<td class=\"shaded\" style=\"width: 80.6306%;height: 15px\">A sick person&#8217;s test results are normal &#8211; failing to detect disease that is present.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Most often, complimentary and follow-up tests are used together to build confidence in a diagnosis, since no single test is 100% accurate.<\/p>\n<table class=\"grid landscape\" style=\"border-collapse: collapse;width: 100%;height: 30px\">\n<tbody>\n<tr style=\"height: 15px\">\n<td class=\"border\" style=\"width: 13.0631%;height: 15px\"><span style=\"color: #032c80\"><strong>Sensitivity<\/strong><\/span><\/td>\n<td style=\"width: 86.9369%;height: 15px\"><strong style=\"text-align: initial;font-size: 1em\">Can a test accurately detect True Positives?\u00a0 <\/strong>A sensitive test is positive in the presence of disease.\u00a0 A 99% sensitive test correctly identifies 99 out of 100 sick people.<\/td>\n<\/tr>\n<tr style=\"height: 15px\">\n<td class=\"shaded\" style=\"width: 13.0631%;height: 15px\"><span style=\"color: #032c80\"><strong>Specificity<\/strong><\/span><\/td>\n<td class=\"shaded\" style=\"width: 86.9369%;height: 15px\"><strong style=\"text-align: initial;font-size: 1em\">Can a test accurately detect True Negatives?<\/strong>\u00a0 A 99% specific test correctly identifies 99 out of 100 healthy people.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"text-align: initial;font-size: 1em\">The typical diagnostic strategy begins with a highly <strong>sensitive<\/strong> test to alert as many people with the disease as possible.\u00a0 A highly <strong>specific<\/strong> test then follows up to identify and reassure healthy individuals who received false positives from the first test.<\/span><\/p>\n<figure id=\"attachment_407\" aria-describedby=\"caption-attachment-407\" style=\"width: 300px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-407 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/Cervical-Cancer-Screening-300x207.png\" alt=\"\" width=\"300\" height=\"207\" srcset=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/Cervical-Cancer-Screening-300x207.png 300w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/Cervical-Cancer-Screening-1024x706.png 1024w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/Cervical-Cancer-Screening-768x530.png 768w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/Cervical-Cancer-Screening-65x45.png 65w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/Cervical-Cancer-Screening-225x155.png 225w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/Cervical-Cancer-Screening-350x241.png 350w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/Cervical-Cancer-Screening.png 1515w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-407\" class=\"wp-caption-text\">Figure: Management algorithm in primary HPV screening. Abnormal cytology refers to a borderline or more severe cytological result. This figure was adapted from Chrysostomou et al. (2018) [15]. This algorithm was developed based on \u201cThe supplements of the second edition of the European Guidelines for Quality Assurance in Cervical Cancer Screening of 2015\u201d<\/figcaption><\/figure>\n<p>In the above figure, a new added step to the protocol for cervical testing is being developed and implemented in some countries.\u00a0 \u00a0The newly added step is the first one, in which a <strong>Primary HPV<\/strong> (Human Papilloma Virus) test, a highly <strong>sensitive<\/strong> test is used that screens for the DNA presence of the HPV strains that are considered high risk for cancer development.\u00a0 The <strong>cytology test<\/strong> involves the <strong>Pap smear<\/strong> with microscopic analysis of cervical cellular morphology.\u00a0 Traditionally, the cytology (Pap smear) test is used as the initial test, and is also considered highly <strong>sensitive<\/strong> with an even greater degree of <strong>specificity<\/strong> than the HPV test.\u00a0 The third test in the above figure, the <strong>colposcopy<\/strong> test is considered a highly <strong>specific<\/strong> test.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_426\" aria-describedby=\"caption-attachment-426\" style=\"width: 300px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-426 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/PocketColposcope-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/PocketColposcope-300x300.jpg 300w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/PocketColposcope-1024x1024.jpg 1024w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/PocketColposcope-150x150.jpg 150w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/PocketColposcope-768x768.jpg 768w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/PocketColposcope-1536x1536.jpg 1536w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/PocketColposcope-2048x2048.jpg 2048w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/PocketColposcope-65x65.jpg 65w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/PocketColposcope-225x225.jpg 225w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/PocketColposcope-350x350.jpg 350w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-426\" class=\"wp-caption-text\">Figure:\u00a0 Pocket Colposcope (2018) Colpscopy is a specificity test performed when abnormal cells are detected in a Pap smear.\u00a0 It involves using a colposcope, a thin flexible tube with lighted, magnifying camera that can examine the cervix, vagina, and vulva for lesions and signs of cancer.<\/figcaption><\/figure>\n<div class=\"mceTemp\"><\/div>\n<figure id=\"attachment_427\" aria-describedby=\"caption-attachment-427\" style=\"width: 300px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-427 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/05\/images_large_10.1177_11769351231161477-fig1-300x86.jpeg\" alt=\"\" width=\"300\" height=\"86\" srcset=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/05\/images_large_10.1177_11769351231161477-fig1-300x86.jpeg 300w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/05\/images_large_10.1177_11769351231161477-fig1-1024x294.jpeg 1024w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/05\/images_large_10.1177_11769351231161477-fig1-768x220.jpeg 768w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/05\/images_large_10.1177_11769351231161477-fig1-1536x441.jpeg 1536w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/05\/images_large_10.1177_11769351231161477-fig1-65x19.jpeg 65w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/05\/images_large_10.1177_11769351231161477-fig1-225x65.jpeg 225w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/05\/images_large_10.1177_11769351231161477-fig1-350x100.jpeg 350w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/05\/images_large_10.1177_11769351231161477-fig1.jpeg 1963w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-427\" class=\"wp-caption-text\">Figure: Anatomical view of cervix (a), cross-sectional view of cervix (b).<\/figcaption><\/figure>\n<figure id=\"attachment_432\" aria-describedby=\"caption-attachment-432\" style=\"width: 300px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-432 size-medium\" src=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/colposcopy-300x198.png\" alt=\"\" width=\"300\" height=\"198\" srcset=\"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/colposcopy-300x198.png 300w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/colposcopy-1024x677.png 1024w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/colposcopy-768x508.png 768w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/colposcopy-65x43.png 65w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/colposcopy-225x149.png 225w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/colposcopy-350x231.png 350w, https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-content\/uploads\/sites\/1961\/2023\/06\/colposcopy.png 1395w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-432\" class=\"wp-caption-text\">Figure: Colposcopy The above figures show the strategy most often used in diagnostic testing, in which the first test used is a highly <strong>Sensitive<\/strong> test, which is very good at identifying illness, and makes sure that you can alert as many people as possible that may have the illness.\u00a0 \u00a0The <strong>Specificity<\/strong> test typically follows the Sensitivity test, and is used to identify false positives (e.g. make sure those that are healthy are correctly identified, and then alerted that they don&#8217;t have the disease,\u00a0 and are not treated for a disease that they don&#8217;t have).<\/figcaption><\/figure>\n<h3><span style=\"color: #1f5c99\"><strong>Ethics of Diagnostic Tests<\/strong><\/span><\/h3>\n<p>The design and use of diagnostic tests raises important ethical questions.\u00a0 Tests are most often developed and used with the following priorities in mind:<\/p>\n<ul>\n<li>A significant percentage of the population is at risk.<\/li>\n<li>Test development is feasible.<\/li>\n<li>The test will be reliable (valid and repeatable).<\/li>\n<li>The test will be sensitive and\/or specific.<\/li>\n<li>The test will be inexpensive and affordable.<\/li>\n<li>The test will be easy to store and deliver.<\/li>\n<li>The test will be user-friendly and not prone to human error.<\/li>\n<li>Ideally, the test is <strong>non-invasive<\/strong> (which also reduces cost and time).<\/li>\n<\/ul>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\"><strong>Examples of Non-Invasive Tests<\/strong><\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p>Non-invasive tests include: blood tests, urinalysis, sputum, and stool sample analysis, x-rays (e.g., mammograms), and physical exams.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<div id=\"h5p-50\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-50\" class=\"h5p-iframe\" data-content-id=\"50\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Pause and Reflect:\u00a0 Most often tests are developed and used with the following priorities involved:\"><\/iframe><\/div>\n<\/div>\n<div class=\"mceTemp\"><\/div>\n<div class=\"media-attributions clear\" prefix:cc=\"http:\/\/creativecommons.org\/ns#\" prefix:dc=\"http:\/\/purl.org\/dc\/terms\/\"><h2>Media Attributions<\/h2><ul><li about=\"https:\/\/commons.wikimedia.org\/wiki\/File:Incentive_Spirometer.png\"><a rel=\"cc:attributionURL\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Incentive_Spirometer.png\" property=\"dc:title\">An illustration depicting an incentive spirometer.<\/a>  &copy;  <a rel=\"dc:creator\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\" property=\"cc:attributionName\">BruceBlaus<\/a>    is licensed under a  <a rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY (Attribution)<\/a> license<\/li><li about=\"https:\/\/commons.wikimedia.org\/wiki\/File:Equipment_-_EEG_(6199)_--_Smart-Servier.png\"><a rel=\"cc:attributionURL\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Equipment_-_EEG_(6199)_--_Smart-Servier.png\" property=\"dc:title\">Private: Equipment_-_EEG_(6199)_&#8211;_Smart-Servier<\/a>  &copy;  <a rel=\"dc:creator\" href=\"https:\/\/smart.servier.com\/category\/general-items\/equipment\/\" property=\"cc:attributionName\">Smart Servier Medical Art<\/a>    is licensed under a  <a rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA (Attribution ShareAlike)<\/a> license<\/li><li about=\"https:\/\/commons.wikimedia.org\/wiki\/File:Parasagittal_MRI_of_human_head_in_patient_with_benign_familial_macrocephaly_prior_to_brain_injury_%28ANIMATED%29.gif\"><a rel=\"cc:attributionURL\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Parasagittal_MRI_of_human_head_in_patient_with_benign_familial_macrocephaly_prior_to_brain_injury_%28ANIMATED%29.gif\" property=\"dc:title\">Private: Parasagittal_MRI_of_human_head_in_patient_with_benign_familial_macrocephaly_prior_to_brain_injury_ANIMATED<\/a>  &copy;  Dwayne Reed    is licensed under a  <a rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA (Attribution ShareAlike)<\/a> license<\/li><li about=\"https:\/\/commons.wikimedia.org\/wiki\/File:Equipment_-_Endoscopy_--_Smart-Servier.png\"><a rel=\"cc:attributionURL\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Equipment_-_Endoscopy_--_Smart-Servier.png\" property=\"dc:title\">Private: Equipment_-_Endoscopy_-_Smart-Servier<\/a>  &copy;  Laboratoires Servier    is licensed under a  <a rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA (Attribution ShareAlike)<\/a> license<\/li><li about=\"https:\/\/online.stat.psu.edu\/stat200\/lesson\/8\/8.2\/8.2.3\/8.2.3.1\/8.2.3.1.2\"><a rel=\"cc:attributionURL\" href=\"https:\/\/online.stat.psu.edu\/stat200\/lesson\/8\/8.2\/8.2.3\/8.2.3.1\/8.2.3.1.2\" property=\"dc:title\">Distribution Plot of Heart Rate<\/a>      is licensed under a  <a rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/\">CC BY-NC (Attribution NonCommercial)<\/a> license<\/li><li about=\"https:\/\/doi.org\/10.3390\/life10110290\"><a rel=\"cc:attributionURL\" href=\"https:\/\/doi.org\/10.3390\/life10110290\" property=\"dc:title\">Cervical Cancer Screening<\/a>  &copy;  Chrysostomou, A.C.; Kostrikis, L.G.    is licensed under a  <a rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY (Attribution)<\/a> license<\/li><li about=\"https:\/\/commons.wikimedia.org\/w\/index.php?curid=75165619\"><a rel=\"cc:attributionURL\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?curid=75165619\" property=\"dc:title\">PocketColposcope<\/a>  &copy;  Erica Skerrett    is licensed under a  <a rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\">CC BY-NC-SA (Attribution NonCommercial ShareAlike)<\/a> license<\/li><li >images_large_10.1177_11769351231161477-fig1  &copy;  Dash S, Sethy PK, Behera SK.    is licensed under a  <a rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\">CC BY-NC-SA (Attribution NonCommercial ShareAlike)<\/a> license<\/li><li about=\"https:\/\/doi.org\/10.1186\/s12916-020-01613-x\"><a rel=\"cc:attributionURL\" href=\"https:\/\/doi.org\/10.1186\/s12916-020-01613-x\" property=\"dc:title\">colposcopy<\/a>  &copy;  Xue, P., Ng, M.T.A. & Qiao, Y.    is licensed under a  <a rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA (Attribution ShareAlike)<\/a> license<\/li><\/ul><\/div>","protected":false},"author":1370,"menu_order":7,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-6261","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":3,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/6261","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":13,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/6261\/revisions"}],"predecessor-version":[{"id":6640,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/6261\/revisions\/6640"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/3"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/6261\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=6261"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=6261"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=6261"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=6261"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}