Targeted case finding for cardiovascular prevention

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c1376 (Published 25 April 2010) Cite this as: BMJ 2010;340:c1376
  1. Tom Marshall, senior lecturer in public health
  1. 1Public Health, Epidemiology and Biostatistics, University of Birmingham, Edgbaston, Birmingham B15 2TT
  1. t.p.marshall{at}bham.ac.uk

    The obvious and sensible choice compared with universal screening

    In the linked study (doi:10.1136/bmj.c1693), Chamnan and colleagues estimate the effect of different screening strategies for identifying and treating people at high risk of cardiovascular disease.1 The study is a clear exposition of some simple ideas—that to get the most from the money spent on preventing heart disease, we should use all the information available to identify and target those most likely to benefit. Compared with universal screening of untreated individuals aged 40-74, the study shows that using a targeted strategy to identify the 20% of the population at highest risk can prevent 50% more cardiovascular disease; targeting the 40% at highest risk can prevent 75% more; and targeting the 60% at highest risk can prevent almost all cardiovascular disease. They may have overestimated the number of people treated under a universal strategy, however, because it is …

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