Health checks do not save lives, Cochrane review finds

Health checks designed to uncover undiagnosed long-term conditions do not cut mortality rates or morbidity, a comprehensive meta-analysis has concluded.

Health checks on the general population do not reduce mortality, the review found
Health checks on the general population do not reduce mortality, the review found

The Cochrane systematic review and meta-analysis found that testing of the general population, through schemes such as NHS Health Checks, does not reduce overall mortality or morbidity. Such schemes also fail to reduce mortality or morbidity from causes such as cardiovascular disease and cancer.

However, UK experts involved in rolling out the NHS Health Checks scheme said the Cochrane review did not evaluate checks similar to NHS scheme.

Dr Lasse Krogsboll and colleagues from the Nordic Cochrane Centre in Copenhagen, Denmark, studied data from 14 trials involving 182,880 people.

Commenting on their findings, the researchers said: ‘We did not find an effect on total or cause-specific mortality from general health checks in adult populations unselected for risk factors or disease. The results suggest that the lack of effect on total mortality is not a chance finding or due to low power, but that there is no, or only a minimal, effect of the intervention on mortality in general adult populations.’

Dr Krogsboll and colleagues found that health checks did increase the number of people with diagnosed conditions, but they suggest that this may not necessarily bring benefits.

‘We did find that health checks led to more diagnoses and more medical treatment for hypertension, as expected, but, as these did not improve mortality or morbidity, they may be considered harms rather than benefits,’ they said.

The researchers said that the lack of benefit from health checks may be a result of the fact that GPs are already assessing at-risk patients and diagnosing and treating them appropriately.

Dr Krogsboll and colleagues said that money should be spent on examining which aspects of health checks may be effective. They also said that surrogate outcomes, such a BP and cholesterol levels, should be used in place of measures of mortality and morbidity to assess the benefits of health checks.

‘The large randomised trials with long follow-up that are required are expensive, but not nearly as expensive as the implementation of ineffective or harmful general health check programmes,’ they concluded.

A spokesman for NHS Diabetes and Kidney Care, commissioned by the DH to support the rollout of health checks, said: 'The very specific questions and risk reduction measures used in the NHS Health Check programme are based on robust health economic evidence and firmly grounded in NICE guidance.

'With the exception of dementia, they focus specifically on vascular conditions. The Cochrane review looks at much more general health check programmes, with some dating as far back as the 1960s. None of them closely resemble the NHS Health Check programme.

'While the review does underline the importance of evaluating the effectiveness of all large scale health initiatives, it does not cast doubt on the effectiveness of the NHS Health Check programme.'

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