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EBM verdict
Primary care
Is it time to end general health checks?
  1. Carl Heneghan,
  2. Kamal R Mahtani
  1. Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Professor Carl Heneghan, Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK; carl.heneghan{at}phc.ox.ac.uk

https://doi.org/10.1136/bmjebm-2019-111227

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    General Health checks are used in several countries. However, the evidence suggests they are not effective and offer low-value healthcare.

    In some countries, general health checks form part of routine healthcare. In the UK, for instance, a National Health Service (NHS) health check is offered to everyone over the age of 40 and under 74. In America, about one in five adults (approximately 64 million Americans) have an annual general examination, costing more than $5 billion.1 However, it is not clear whether health checks are effective for improving morbidity, quality of life or mortality.

    A recent update of a Cochrane review aimed to quantify the benefits and harms of health checks (defined as ‘screening for more than one disease or risk factor in more than one organ system’) in healthy adults compared with no checks.2

    The review included 17 randomised trials, of which 15 reported outcome data for 251 891 participants. Nine of the trials were set in a medical centre, five in general practice and one in a workplace setting. Overall health checks did not affect total mortality, risk ratio (RR) …

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    Footnotes

    • Contributors CH wrote the first draft and KRM provided edits and intellectual input. Both authors approved the final draft.

    • Competing interests CH and KRM are supported by the NIHR School for Primary Care Research Evidence Synthesis Working group (NIHR SPCR ESWG project 390). CH is also supported by the NIHR Oxford Biomedical Research Centre, is an NIHR Senior Investigator and Editor in Chief of BMJ Evidence-Based Medicine. KRM is an Associate Editor of BMJ EBM.

    • Patient consent for publication Not required.

    • Provenance and peer review Commissioned; internally peer reviewed.