General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis

摘要: Objectives To quantify the benefits and harms of general health checks in adults with an emphasis on patient-relevant outcomes such as morbidity mortality rather than surrogate outcomes. Design Cochrane systematic review meta-analysis randomised trials. For mortality, we analysed results random effects meta-analysis, for other did a qualitative synthesis was not feasible. Data sources Medline, EMBASE, Healthstar, Library, Central Register Controlled Trials, CINAHL, EPOC register, ClinicalTrials.gov, WHO ICTRP, supplemented by manual searches reference lists included studies, citation tracking (Web Knowledge), contacts trialists. Selection criteria Randomised trials comparing no adult populations unselected disease or risk factors. Health defined screening more one factor organ system. We include geriatric extraction Two observers independently assessed eligibility, extracted data, bias. contacted authors additional trial details when necessary. Results identified 16 trials, 14 which had available outcome data (182 880 participants). Nine provided total (11 940 deaths), they gave ratio 0.99 (95% confidence interval 0.95 to 1.03). Eight cardiovascular (4567 1.03 (0.91 1.17), eight cancer (3663 1.01 (0.92 1.12). Subgroup sensitivity analyses alter these findings. find beneficial morbidity, hospitalisation, disability, worry, physician visits, absence from work, but all reported One found that led 20% increase number new diagnoses per participant over six years compared control group increased people self chronic conditions, prevalence hypertension hypercholesterolaemia. out four use antihypertensives. small health, could be due Conclusions General reduce neither overall nor causes, although diagnoses. Important harmful were often studied reported. Systematic registration doi:10.1002/14651858.CD009009.