18 October 2012

Are medical examinations a waste of time?

The authors of a meta-analysis (Krogsboll et al., General health checks in adults for reducing morbidity and mortality from disease), published in The Cochrane Library journal, concluded that medical examinations aimed at general health assessment do not reduce either overall mortality or mortality from serious diseases, such as like cancer and heart disease.

In some countries, general medical examinations are a component of standard medical practice. The purpose of their implementation is to reduce the number of deaths or deterioration of health due to early diagnosis and treatment of diseases. However, such examinations can also cause negative consequences – for example, the identification and treatment of conditions that could never lead to the appearance of symptoms of diseases or to a reduction in life expectancy.

When compiling the review, scientists from the Scandinavian center of the Cochrane Society in Copenhagen (Sweden) analyzed the results of 14 clinical trials in which 182,880 people participated. During all the studies, the participants were divided into at least two groups, one of which was invited for a medical examination, and the other was not. In one study, a medical examination increased the number of diagnoses of all the diseases under consideration. In another, people who were invited to a medical examination were more likely than one would assume to have high blood pressure or high cholesterol. In three other studies, a large number of deviations were detected in the groups that underwent screening.

At the same time, when analyzing the results of 9 longitudinal studies, in which 11,940 deaths were registered, in the long term, the authors did not reveal any differences between the examined and non-examined groups. Moreover, this was true for both total mortality and mortality from cancer or heart disease. Other outcomes were evaluated much less closely, but the available data indicate that medical examinations do not affect any of the following parameters: the number of hospitalizations, disability, concern about their health, the number of referrals to narrow specialists, additional visits to doctors and the duration of sick leave.

According to the authors, they do not claim that doctors should stop conducting examinations or offering treatment in cases where they suspect the existence of a problem. However, they are of the opinion that it is necessary to resist initiatives on the part of health care, which consist in recommendations for systematic medical examinations.

According to the review, when conducting new studies, attention should be paid to the individual components of medical examinations and improving the quality of targeted detection of conditions such as kidney disease and diabetes mellitus. The aim of the research should be to further identify the harmful effects of general medical examinations, which are often ignored, resulting in erroneous conclusions about the ratio of benefits and harm brought by such examinations. Another problem is that the people following the invitation to the examination may be different from the people ignoring this question. For example, paradoxically, people who are at risk of developing serious diseases are highly likely to evade medical examinations.

Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru based on Wiley materials:
Cochrane Review Finds No Benefit from Routine Health Checks.


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