General health checks in adults for reducing morbidity and mortality from disease

Krogsbøll, Lasse T; Jørgensen, Karsten Juhl; Gøtzsche, Peter C

doi:10.1002/14651858.cd009009.pub2

Cited by 238 publications

(218 citation statements)

References 202 publications

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“…However, our findings mirror those of a pragmatic, parallel-group, cluster-randomised trial in 33 general practices in eastern England (ADDITION-Cambridge) [8], in which screening for type 2 diabetes in those at high risk did not result in a reduction in all-cause or cardiovascular-or diabetesrelated mortality rates over 10 years. Our results also reaffirm a recent Cochrane review [10], which found no long-term impact of general health checks on mortality and morbidity rates following population screening.…”

Section: Discussionsupporting

confidence: 91%

“…There are relatively few trials assessing the benefits and harms of screening at the population level [8,9]. A Cochrane review of randomised trials comparing health checks with no health checks in adult populations found that they did not reduce morbidity, all-cause mortality or cardiovascular-related mortality rates, although the number of new diagnoses increased [10]. The review included data from a number of historical cohorts that were initiated before the widespread introduction of effective treatments such as statins.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of population screening for type 2 diabetes and cardiovascular risk factors on mortality rate and cardiovascular events: a controlled trial among 1,912,392 Danish adults

et al. 2017

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Aims/hypothesis Health check programmes for chronic disease have been introduced in a number of countries. However, there are few trials assessing the benefits and harms of these screening programmes at the population level. In a post hoc analysis, we evaluated the effect of population-based screening for type 2 diabetes and cardiovascular risk factors on mortality rates and cardiovascular events. Methods This register-based, non-randomised, controlled trial included men and women aged 40-69 years without known diabetes who were registered with a general practice in Denmark (n = 1,912,392). Between 2001 and 2006, 153,107 individuals registered with 181 practices participating in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION)-Denmark study were sent a diabetes risk score questionnaire. Individuals at moderate-to-high risk were invited to visit their GP for assessment of diabetes status and cardiovascular risk (screening group). The 1,759,285 individuals registered with all other general practices in Denmark constituted the retrospectively constructed no-screening (control) group. Outcomes were mortality rate and cardiovascular events (cardiovascular disease death, non-fatal ischaemic heart disease or stroke). The analysis was performed according to the intention-to-screen principle. Results Among the screening group, 27,177 (18%) individuals attended for assessment of diabetes status and cardiovascular risk. Of these, 1,533 were diagnosed with diabetes. During a median follow-up of 9.5 years, there were 11,826 deaths in the screening group and 141,719 in the no-screening group (HR 0.99 [95% CI 0.96, 1.02], p = 0.66). There were 17,941 cardiovascular events in the screening group and 208,476 in the no-screening group (HR 0.99 [0.96, 1.02], p = 0.49). Conclusions/interpretation A population-based stepwise screening programme for type 2 diabetes and cardiovascular risk factors among all middle-aged adults in Denmark was not associated with a reduction in rate of mortality or cardiovascular events between 2001 and 2012.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Effect of population screening for type 2 diabetes and cardiovascular risk factors on mortality rate and cardiovascular events: a controlled trial among 1,912,392 Danish adults

et al. 2017

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“…Addition of routine periodic health reviews does not seem to add value. Indeed, two very large systematic reviews and meta-analyses concluded that general practice periodic health increased medication utilization and use of diagnostic testing but did not accrue any net benefit in terms of improved overall or disease specific mortality (2,3). Similarly, in most cases, undirected, population-wide screening for most chronic conditions does not add value to targeted screening of patients presenting for episodic health care who are opportunistically identified as having clinical risk factors for a target condition.…”

mentioning

confidence: 99%

Screening Strategies for Unrecognized CKD

Komenda

Rigatto

Tangri

2016

CJASN

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“…A recent example of a Cochrane review that has important clinical and policy implications concerns the use of general health checks in adults, shown not to reduce morbidity and mortality, despite the fact that the UK government began a policy of health checks for adults in 2009. 6 We urge readers to take a more critical view of the medical literature and its relevance to their clinical practice. Cochrane reviews remain key components for GPs who wish to remain safe and effective doctors.…”

mentioning

confidence: 99%