Health checks in general practice: evidence first, not last
Por:
Lopez-Garcia-Franco, A, Pardo-Hernandez, H, Fraile-Navarro, D, Alonso-Coello, P
Publicada:
1 ene 2016
Resumen:
Despite being ubiquitous in primary care, there is no accepted consensus on the definition and main components of health checks. They range from periodic health evaluations with a general physician, through the screening and diagnostic tests derived from these visits, to broader screening programs. Health checks may promote a fluid patient-provider relationship, improve the delivery of some preventive measures, and reduce the patient's anxiety. However, they can also expose patients to overdiagnosis and unnecessary interventions.
Research on the benefits, harms, and cost-effectiveness of health checks is limited. As a consequence, health checks and screening programs are implemented in several countries and supported by national scientific societies based chiefly on their potential benefits on surrogate outcomes. There is also substantial variability regarding the target population (eg, initial age), tests, or intervals. We call for a rigorous assessment of the net effect of all health checks, taking into consideration common biases (eg, sticky-diagnosis and slippery-linkage biases), patient-important outcomes, potential adverse events, cost-effectiveness, as well as equity and feasibility of the proposed programs.
Filiaciones:
Lopez-Garcia-Franco, A:
Ctr Salud Dr Mendiguchia Carriche Leganes, Madrid, Spain
Pardo-Hernandez, H:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, Barcelona, Spain
Fraile-Navarro, D:
Ctr Salud Dr Mendiguchia Carriche Leganes, Madrid, Spain
Alonso-Coello, P:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, Barcelona, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Bronze
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