In an accompanying editorial, Dr. Domhnall MacAuley, the London-based clinical primary care editor for BMJ, alluded to some unintended consequences that can stem from ineffective checkups.
"The potential downsides," MacAuley said, "are that those who come [in for a checkup] tend to be the 'worried well,' who may bear a high risk for being diagnosed with false positives or negatives. Indeed, [the study authors] suggested that there was overdiagnosis -- that routine checks tend to pick up conditions that were treated with no obvious benefit in terms of [illness] or mortality."
In his published commentary, MacAuley concluded that "policy should be based on evidence of well-being, rather than on well-meant good intentions" and rejects the notion that checkups for a healthy public are a good idea simply because "they seem a socially responsible approach to caring for patients."
That said, he suggests that "targeted" checkups may be the alternate way to go, by focusing on those patients who have already been identified as having risk factors or conditions that could benefit from routine monitoring.
SOURCES: Lasse T. Krogsboll, Ph.D. candidate, Nordic Cochrane Centre, Righospitalet, Copenhagen; Domhnall MacAuley, M.D., clinical primary care editor, BMJ Edi
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