BMJ  2008;336:123 (19 January), doi:10.1136/bmj.39461.502581.59

Observations

A few lessons in screening for Gordon Brown

doi: 10.1136/bmj.39461.484132.59

The prime minister seems just to want to offer more consumer choice for the worried well

The first 150 words of the full text of this article appear below.

Prime Minister Gordon Brown has just announced that he will allocate funding for a national screening programme concentrated on diabetes, cardiovascular and renal diseases, and stroke (BMJ 2008;336:62-3 doi:10.1136/bmj.39454.738912.4E). He said these were now seldom available except through private care but would, over the next three years, be made available to everyone.

The politicians, civil servants, and managers who devised this plan may believe it is evidence based. I’m not so sure. So far as I know, there has been only one controlled trial of such a policy. This compared age standardised mortality over five years associated with traditional demand-led care alone in Blaengwynfi, against similar care in Glyncorrwg, where this had been integrated with proactive screening and follow-up for chronic conditions (which included those listed by the prime minister) over the previous 20 years.¹ The two communities were socially almost identical. Both were in the bottom . . . [Full text of this article]

Nearly an ideal experiment?

An untrodden path

Preconditions for success

Competition
Targetting
Integration

Full population coverage

Winning votes

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