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JAMA Intern Med：普通健康体检未能降低死亡率

2013-01-22 JAMA Intern Med CMT 高晓方 编译

普通健康体检死亡率新诊断高血压糖尿病高脂血症
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　　丹麦学者的一项荟萃分析综述表明，普通健康体检未能降低总体死亡率。该综述1月14日在线发表于《JAMA内科学》（JAMA Intern Med）。 　　此项荟萃分析共纳入14项于1963至1999年间实施的随机对照试验，并评估了年度体检对发病率和死亡率的影响。以仅用于预防咨询和筛查的就诊定义普通体检，排除慢性病治疗或紧急救护所引发的就诊。纳入试验共涉及182,000余例患者

　　丹麦学者的一项荟萃分析综述表明，普通健康体检未能降低总体死亡率。该综述1月14日在线发表于《JAMA内科学》（JAMA Intern Med）。

　　此项荟萃分析共纳入14项于1963至1999年间实施的随机对照试验，并评估了年度体检对发病率和死亡率的影响。以仅用于预防咨询和筛查的就诊定义普通体检，排除慢性病治疗或紧急救护所引发的就诊。纳入试验共涉及182,000余例患者。主要转归为全因死亡率和疾病特异性死亡率。次要转归包括发病率、新诊断、住院、残疾、焦虑、自报健康、专科转诊和附加全科就诊。

　　结果显示，普通体检对总体死亡率无显著影响（危险比[RR] 0.99）；对生活访视咨询、随访持续时间和检查类型等其他因素进行评估后结果亦为如此。就疾病特异性死亡率而言，普通体检未显著降低癌症死亡率（RR 1.01）或心血管死亡率（RR 1.03）。仅部分研究纳入次要转归资料；结果显示体检期间新诊断高血压、高脂血症和糖尿病例数增多。


General Health Checks in Adults for Reducing Morbidity and Mortality From Disease:Summary Review of Primary Findings and Conclusions

The concept of general health checkups to identify disease at a stage at which early intervention could be effective has been promoted for nearly 100 years.1 Both patients and primary care physicians are interested in such examinations, which can include detailed history taking, physical examination, extensive laboratory testing, and imaging. However, there has been little evidence to support the benefits of such checkups, and the US Preventive Services Task Force recommends a limited range of age-, sex-, and risk-specific examinations and tests. The goal of this review was to estimate the effect of health checkups on morbidity and mortality based on primary care–or community-based randomized controlled trials (RCTs) with long-term follow-up in adults.

    

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    2013-01-24 marongnuan

    #体检#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1305071, encodeId=09d613050e1bc, content=<a href='/topic/show?id=ba392659e58' target=_blank style='color:#2F92EE;'>#体检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26597, encryptionId=ba392659e58, topicName=体检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b191324, createdName=marongnuan, createdTime=Thu Jan 24 02:51:00 CST 2013, time=2013-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552814, encodeId=4d94155281430, content=<a href='/topic/show?id=0be52e73714' target=_blank style='color:#2F92EE;'>#健康体检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27737, encryptionId=0be52e73714, topicName=健康体检)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=89dc14300603, createdName=gaoxiaoe, createdTime=Thu Jan 24 02:51:00 CST 2013, time=2013-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1605892, encodeId=a2a71605892ab, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Jan 24 02:51:00 CST 2013, time=2013-01-24, status=1, ipAttribution=)]
    2013-01-24 gaoxiaoe

    #健康体检#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1305071, encodeId=09d613050e1bc, content=<a href='/topic/show?id=ba392659e58' target=_blank style='color:#2F92EE;'>#体检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26597, encryptionId=ba392659e58, topicName=体检)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b191324, createdName=marongnuan, createdTime=Thu Jan 24 02:51:00 CST 2013, time=2013-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552814, encodeId=4d94155281430, content=<a href='/topic/show?id=0be52e73714' target=_blank style='color:#2F92EE;'>#健康体检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27737, encryptionId=0be52e73714, topicName=健康体检)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=89dc14300603, createdName=gaoxiaoe, createdTime=Thu Jan 24 02:51:00 CST 2013, time=2013-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1605892, encodeId=a2a71605892ab, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu Jan 24 02:51:00 CST 2013, time=2013-01-24, status=1, ipAttribution=)]
    2013-01-24 ms3994565386320060

    #Med#

    0