Health Checks Are Bad For You? You Can't Be Serious!

Many of you may have read the recent news articles quoting the findings from a published review by the Cochrane Collaboration. The overall conclusion was that hat general health checks in adults do not reduce illness or death, and in fact may cause harm. On the face of it the findings seem counter intuitive to the modern practice of preventive medicine so I thought it was well worth the time and effort to have a look at the research paper and make my own mind up. The write up of the research study was published in the BMJ, but the full analysis, including some of the data not presented in the BMJ article, is available from the Cochrane Library.

The Cochrane Collaboration of researchers is a well respected group, who do a number of systematic reviews of published research to try and get to a "global truth" about a particular question. In essence what they did with this piece of work was look back at published scientific articles that specifically examined the impact of health checks on patient outcomes and pooled all of the results together to give an overview of the effect. In a way its a bit like Trip Advisor, but for research that has already been published.

The first thing that struck me when reading the BMJ paper was that the previously published research articles included in this overall review were really quite old. Eleven of the fourteen previous studies used for the review were conducted before 1990, with the oldest being from 1963. In fact six of the fourteen are from the 1960s. The world has changed a great deal in the intervening 50 years, and so has the practice of medicine. To state that health checks have no discernible benefits for participants, and may in fact cause harm, and to base this on studies from the 1960s is not logical, and could potentially be seen as being misleading.

As well as this the researchers did not analyze previously published research studies that looked at single-intervention health checks. The sort of things we are talking about are studies that have looked at the benefits of screening for specific diseases or conditions like prostate cancer, COPD or colon cancer. This again makes very little sense as there is a lot of evidence to support the impact of specific screening tests on morbidity and mortality.

The final aspect of the study selection methods that I found rather curious was the fact that the authors did not include research on health checks conducted on individuals who were over the age of 65. Their justification for this was that the published research on health checks for older adults often included additional interventions such as falls prevention and medication reviews. This just doesn't make any sense. Its like saying I'm only going to look at Trip Advisor ratings from people who rate hotels...if they also rate restaurants and holiday rentals then I am going to ignore what they have to say.

With these inconsistencies and methodological issues I leave it up to you to decide whether the conclusions reached by the authors of this piece of research are valid or not. My opinion is that annual health checks are a valuable and important part of a proactive approach to population health management. The NHS in the UK and Medicare in the US have definitely got the right approach with their fully covered health and wellness visits....long may this common sense prevail!