Featured Review: Are general health checks beneficial?

Do general health checks reduce illness and death?

Do general health checks reduce illness and death?

The authors of this updated Cochrane Review set out to find if general health checks reduce illness and deaths.

General health checks involve multiple tests in a person who does not feel ill. The purpose is to find disease early, prevent disease from developing, or provide reassurance. Health checks are a common element of health care in some countries. Experience from screening programmes for individual diseases have shown that the benefits may be smaller than expected and the harms greater. The review authors identified and analysed all randomised trials that compared invitations for one or more health checks for the general public with no invitations. They analysed the effect on illness and the risk of death, as well as other outcomes that reflect illness, for example, hospitalisation and absence from work.

The authors found fifteen trials reported results and included 251,891 participants. Eleven of these trials had studied the risk of death and included 233,298 citizens and assessed 21,535 deaths.

Lead author of this Cochrane Review, Lasse T Krogsbøll said;

"One reason for the apparent lack of effect may be that primary care physicians already identify and intervene when they suspect a patient is at high risk of developing disease when they see them for other reasons. Also, those at high risk of developing disease may not attend general health checks when invited or may not follow suggested tests and treatments.

But the conclusions do not imply that physicians should stop clinically motivated testing and preventive activities, as such activities may be an important reason why an effect of general health checks has not been shown.

This update addresses a criticism of the previous version of the review, that the included trials were old and were not done when statins were available. The evidence base has also substantially strengthened, as the previous review had data from 150,000 patients, we now have data from 230,000.

In the future we suggest research focus is shifted to the effects of structural interventions to reduce disease, for example, higher taxes on tobacco and alcohol, or restricting corporate advertising for harmful products."

Wednesday, February 20, 2019