BMJ 1994;308:852 (26 March)

Letters

Health promotion in general practice

Doctors have a duty to the whole community

Editor,--The Oxcheck Researchers and the Family Heart Study Group doubt whether multifactorial risk ascertainment and counselling of whole populations are worth the effort.1 2 What, however, did they expect from a population approach? Optimistically these studies might lead to a reduction in mortality from ischaemic heart disease of 4-8%. This compares with an annual fall in mortality from this cause currently around 7%. Sustaining change with margins of 1-2% is made easier by realistic expectations. The lower than average risk in the study populations makes the additional changes (when not due to the study design) even more impressive.

Wald et al also doubt the value of multifactorial risk assessment for whole populations.3 Devoting more effort to those at higher risk has been shown to yield greater individual returns (though with limited community gain). To identify those at higher risk, the risk for the . . . [Full text of this article]


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Relevant Article

Effectiveness of health checks conducted by nurses in primary care: results of the OXCHECK study after one year
J Muir, D Mant, L Jones, and P Yudkin
BMJ 1994 308: 308-312. [Abstract] [Full Text]

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