Meta-analysis of RCTs of “health checks” — limited data on effectiveness

Clinical Question

How effective are periodic comprehensive health assessments (“health checks”) in primary care?


Bottom Line:

The existing body of research on periodic comprehensive health assessments is not able to determine if these “health checks” are meaningful. (LOE = 1a-)

Reference

Si S, Moss JR, Sullivan TR, Newton SS, Stocks NP. Effectiveness of general practice-based health checks: a systematic review and meta-analysis. Br J Gen Pract 2014;64(618):e47-e53.

Study Design: Meta-analysis (other)

Funding: Government

Setting: Outpatient (primary care)

Allocation: Unknown

Synopsis

These authors searched several databases, as well as the Cochrane Central Register of Controlled Trials, to identify English-language randomized trials (randomized, cluster-randomized, pseudo-randomized) that compared the health outcomes of general practice-based health checks versus usual care in middle-aged participants. The authors don’t specify how they determined study inclusion, or if the data extraction and quality assessment of included studies was done in a masked and independent manner. Ultimately, they included 6 studies. The authors don’t report how many patients were included or the duration of follow-up in these studies. Virtually all the studies evaluated surrogate measures (eg, blood pressure, cholesterol, and so forth). The studies generally had significant sources of bias: lack of masking, high loss to follow-up, selection bias. Although the authors present a variety of improvements in surrogate markers, none are really clinically important. The authors reported no difference in overall mortality.

Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI
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