In an article published in the journal Evidence Based Nursing, I comment on a recent Cochrane review of general health checks. These are checks that aim to detect risk factors and diseases in healthy people, with the aim of either preventing a disease from developing, or treating a disease earlier in its course. The systematic review of randomised controlled trials (RCTs) of general health checks found that they did not reduce morbidity or mortality, but did increase the number of new diagnoses. The review did though have several limitations. The trials included differed markedly in their definition of what constituted a ‘general health check’ and in the disease they were aiming to address. They also differed in how any newly identified risk factors or disease would be managed. In many studies, the only intervention offered was brief lifestyle advice. Some of the trials were also old, dating from the 1960s. Many of the currently available risk reduction interventions (such as the widespread use of electronic patient records for targeting specific patient groups, tools for measuring individual cardiovascular risk, and low-cost statins for primary prevention) were unavailable at the time most of these trials were carried out.
As part of a session on primary care data in the Health Informatics module on the Imperial Master of Public Health Programme, I asked students to work in two groups to present arguments for and against the NHS Care.Data programme. Care.Data is an NHS programme that will extract data from the medical records held by general practitioners (GPs) in England. The Care.Data programme takes advantage of the very high level of use of electronic medical records by GPs in England. After extraction, data will be uploaded to the NHS Health and Social Care Information Centre (HSCIC). The data will then be used for functions such as health care planning, monitoring disease patterns and research. The programme has been controversial with proponents arguing that the programme will bring many benefits for the NHS and the population of England; and opponents arguing it is a major breach of privacy. You can view the two presentations to help inform you further about these arguments: Arguments fo...
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