Health promotion in general practice

BMJ 1994;308:852 (26 March)

Letters

Health promotion in general practice

Refine the approach--don't abandon the principle

Editor,--The problem with interpreting both the Family HeartStudy Group's report of its one year trial¹ and the result ofthe less interventionist OXCHECK study² is that both studiestripped at the second hurdle for any clinical trial: after randomisationthey failed to "screen" their controls in exactly the same wayas they screened the intervention group. The Family Heart StudyGroup devotes much discussion to the ifs and buts of what thecontrol results might have been and halve the observed reductionin coronary risk score to compensate. In the OXCHECK study,the figure seems to indicate, half the intervention group wascompared with itself (previously measured at baseline) and halfwith people who were screened for the first time in year 3--notthe tidiest design and confounded by remeasurement bias. Theselabour saving designs were no doubt adopted because of restrictedfunds. . . . [Full text of this article]

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Relevant Article

Randomised controlled trial evaluating cardiovascular screening and intervention in general practice: principal results of British family heart study: D A Wood, A L Kinmonth, G A Davies, J Yarwood, S G Thompson, S D M Pyke, Y Kok, R Cramb, C Le Guen, T M Marteau, and P N Durrington
BMJ 1994 308: 313-320. [Abstract] [Full Text]