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General health checks in adults for reducing morbidity and mortality from disease

Overview of attention for article published in Cochrane database of systematic reviews, September 1996
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#5 of 8,712)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (98th percentile)

Mentioned by

news
15 news outlets
blogs
16 blogs
policy
2 policy sources
twitter
962 tweeters
facebook
44 Facebook pages
wikipedia
2 Wikipedia pages
googleplus
1 Google+ user
reddit
2 Redditors

Readers on

mendeley
264 Mendeley
citeulike
4 CiteULike
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Title
General health checks in adults for reducing morbidity and mortality from disease
Published in
Cochrane database of systematic reviews, September 1996
DOI 10.1002/14651858.cd009009.pub2
Pubmed ID
Authors

Lasse T Krogsbøll, Karsten Juhl Jørgensen, Christian Grønhøj Larsen, Peter C Gøtzsche, Krogsbøll, Lasse T, Jørgensen, Karsten Juhl, Grønhøj Larsen, Christian, Gøtzsche, Peter C, Krogsbøll LT; Jørgensen KJ; Grønhøj Larsen C; Gøtzsche PC, Lasse T Krogsbøll; Karsten Juhl Jørgensen; Christian Grønhøj Larsen; Peter C Gøtzsche

Abstract

General health checks are common elements of health care in some countries. These aim to detect disease and risk factors for disease with the purpose of reducing morbidity and mortality. Most of the commonly used screening tests offered in general health checks have been incompletely studied. Also, screening leads to increased use of diagnostic and therapeutic interventions, which can be harmful as well as beneficial. It is, therefore, important to assess whether general health checks do more good than harm. We aimed to quantify the benefits and harms of general health checks with an emphasis on patient-relevant outcomes such as morbidity and mortality rather than on surrogate outcomes such as blood pressure and serum cholesterol levels. We searched The Cochrane Library, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, MEDLINE, EMBASE, Healthstar, CINAHL, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) to July 2012. Two authors screened titles and abstracts, assessed papers for eligibility and read reference lists. One author used citation tracking (Web of Knowledge) and asked trialists about additional studies. We included randomised trials comparing health checks with no health checks in adults unselected for disease or risk factors. We did not include geriatric trials. We defined health checks as screening general populations for more than one disease or risk factor in more than one organ system. Two authors independently extracted data and assessed the risk of bias in the trials. We contacted authors for additional outcomes or trial details when necessary. For mortality outcomes we analysed the results with random-effects model meta-analysis, and for other outcomes we did a qualitative synthesis as meta-analysis was not feasible. We included 16 trials, 14 of which had available outcome data (182,880 participants). Nine trials provided data on total mortality (155,899 participants, 11,940 deaths), median follow-up time nine years, giving a risk ratio of 0.99 (95% confidence interval (CI) 0.95 to 1.03). Eight trials provided data on cardiovascular mortality (152,435 participants, 4567 deaths), risk ratio 1.03 (95% CI 0.91 to 1.17) and eight trials on cancer mortality (139,290 participants, 3663 deaths), risk ratio 1.01 (95% CI 0.92 to 1.12). Subgroup and sensitivity analyses did not alter these findings.We did not find an effect on clinical events or other measures of morbidity but one trial found an increased occurrence of hypertension and hypercholesterolaemia with screening and one trial found an increased occurence of self-reported chronic disease. One trial found a 20% increase in the total number of new diagnoses per participant over six years compared to the control group. No trials compared the total number of prescriptions, but two out of four trials found an increased number of people using antihypertensive drugs. Two out of four trials found small beneficial effects on self-reported health, but this could be due to reporting bias as the trials were not blinded. We did not find an effect on admission to hospital, disability, worry, additional visits to the physician, or absence from work, but most of these outcomes were poorly studied. We did not find useful results on the number of referrals to specialists, the number of follow-up tests after positive screening results, or the amount of surgery. General health checks did not reduce morbidity or mortality, neither overall nor for cardiovascular or cancer causes, although the number of new diagnoses was increased. Important harmful outcomes, such as the number of follow-up diagnostic procedures or short term psychological effects, were often not studied or reported and many trials had methodological problems. With the large number of participants and deaths included, the long follow-up periods used, and considering that cardiovascular and cancer mortality were not reduced, general health checks are unlikely to be beneficial.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 264 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 8 3%
Spain 3 1%
United States 3 1%
Germany 2 <1%
Denmark 2 <1%
Ireland 2 <1%
Canada 2 <1%
France 1 <1%
Australia 1 <1%
Other 5 2%
Unknown 235 89%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 56 21%
Student > Master 47 18%
Researcher 36 14%
Student > Bachelor 25 9%
Student > Postgraduate 23 9%
Other 77 29%
Readers by discipline Count As %
Medicine and Dentistry 168 64%
Nursing and Health Professions 19 7%
Psychology 16 6%
Social Sciences 15 6%
Unspecified 12 5%
Other 34 13%

Attention Score in Context

This research output has an Altmetric Attention Score of 857. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 September 2017.
All research outputs
#2,846
of 8,659,198 outputs
Outputs from Cochrane database of systematic reviews
#5
of 8,712 outputs
Outputs of similar age
#23
of 106,591 outputs
Outputs of similar age from Cochrane database of systematic reviews
#1
of 90 outputs
Altmetric has tracked 8,659,198 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 8,712 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 19.0. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 106,591 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 90 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 98% of its contemporaries.