Intended for healthcare professionals

Letters Universal health checks

Universal health checks should be abandoned

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5227 (Published 04 September 2013) Cite this as: BMJ 2013;347:f5227
  1. Lasse T Krogsbøll, researcher1,
  2. Karsten Juhl Jørgensen, senior researcher1,
  3. Peter C Gøtzsche, professor1
  1. 1Nordic Cochrane Centre, Rigshospitalet, Blegdamsvej 9, 2100 Ø, Denmark
  1. ltk{at}cochrane.dk

Last autumn, a Cochrane review (also in the BMJ) on general health checks in adults found no benefit for morbidity and mortality from disease.1 2 NHS Diabetes and Kidney Care and the Department of Health published an eBulletin, “Response to the Cochrane review,” on the NHS Health Check programme’s website.3 It looks like serious criticism of our work, but it is unfounded and misleading.4

We sent a response to the eBulletin to the national director of NHS Diabetes and Kidney Care and asked for it to be published on the website, but this was declined. The NHS letter stated that government had already decided that “NHS Health Checks will be carried out as a national priority,” that the website is not a forum for debating the merits of such checks, and that “there are other more appropriate places to discuss government policy.” Why then did the programme publish its criticism on its website and not in a scientific journal?3

It is interesting to contrast the reactions to our review in the UK and Denmark. In the UK, the programme was defended rigorously. In Denmark, the implementation of systematic health checks was high on our new government’s agenda. However, the Danish minister of health stated: “The analysis from the Nordic Cochrane Centre does not come as a surprise” and decided to put such checks “on ice.”5

Screening programmes for healthy people are justifiable only when randomised trials clearly show that benefits outweigh harms.6 For health checks, the trials seem to show the opposite.2

An administration’s automatic defence of an existing screening programme can be viewed as a self interested response, given the investment of public funds and prestige, and it threatens the very idea of evidence based public healthcare, particularly when it means refusing open scientific debate.

Notes

Cite this as: BMJ 2013;347:f5227

Footnotes

References

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