Health checks without benefit?

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Chochrane study shows no positive effects of general health checks

General health checks at the doctor are nowadays often used to identify possible diseases at an early stage and to be able to counteract them therapeutically. However, a recent study by researchers at the Cochrane Collaboration comes to the conclusion that the health checks have no effect on the morbidity and mortality of the patients.

Although diseases such as high blood pressure or hypercholesterolemia were found to be significantly more common in patients with health checks, the "general health checks do not lead to a reduction in morbidity or mortality, neither overall nor for specific cardiovascular or cancer diseases", they report Researchers around Lasse T Krogsbøll from the Nordic Cochrane Center online in "The Chochrane Libary". As a result, health checks may be of no benefit to patients.

Health of 180,000 patients checked As part of their study, the scientists at the Nordic Chochrane Center in Copenhagen (Denmark) checked 14 previous examinations that offered a comparison between patients with regular health checks and a control group without corresponding medical checks. The studies considered were from 1963 to 1999 and included a total of 182,880 participants. Nine studies explicitly examined possible connections with the risk of death (155,899 participants, 11,940 deaths). According to the researchers, the health checks showed no effect on overall mortality and the risk of death from cardiovascular diseases or cancer.

Increased number of new diagnoses through health checks However, the health checks actually diagnosed more illnesses among the patients. One of the studies evaluated found “a growing number of people with high blood pressure and high cholesterol”, report Lasse Krogsbøll and colleagues. The study also identified an increased number of chronic diseases among patients with health checks. One of the earlier studies also came to the conclusion that the total number of new diagnoses per participant in the group with health check increased by 20 percent over six years compared to the control group. However, the increased diagnosis of the diseases had no effect on mortality.

Health checks with no effect on mortality According to the Danish researchers, overall mortality during follow-up was 75 out of 1,000 in the control group and 74 out of 1,000 among the participants with health checks. For the separately considered deaths as a result of cardiovascular diseases and cancer, there was a comparably small difference between the control group and the intervention group. Here 37 out of 1,000 subjects in the control group and 38 out of 1,000 subjects with health checks died. In cancer mortality, the values ​​of both groups even matched (21 out of 1,000). An effect of the health checks on the death rate could therefore not be determined.

Do not extend health checks With the frequency of illnesses, such as coronary heart disease, non-fatal heart attacks and strokes, and chronic illnesses, there were also no advantages from the health checks. "One reason for the apparently low effectiveness of the health checks can be that general practitioners can recognize and intervene in health problems even without them if they care for a patient with a high risk of illness," write the researchers at the Nordic Chochrane Center. Therefore, the study results should not be misunderstood as a call to stop health checks. In the event of clinical suspicion, these are always appropriate. However, the Danish researchers see no point in the systematic introduction of general health checks for the entire population. (fp)

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