Annual physical exams

See ((General health checks))

Annual primary care visits traditionally includes a detailed interim history, comprehensive physical exam and a set of tests and possible immunizations for the purpose of health promotion and disease prevention.

General health checks increase the number of new diagnoses of diseases, but they do not reduce morbidity or mortality overall or from cancer or cardiovascular causes.

The Cochrane center in Denmark reviewed 14 randomized controlled trials of health checkups involving 182,000 patients: No significant effect was noted on total mortality and similarly no significant reduction in cardiovascular mortality or cancer mortality.

The above studies found no significant effect on hospitalizations.

Randomized studies comparing the outcomes of patients undergoing periodic health checks or no health checks find that the examinations do not reduce morbidity or mortality from cardiovascular disease or cancer.

Studies have shown an increase in the number of patients diagnosed with hypertension, hyperlipidemia, and diabetes.

Studies have shown no significant impact in the number of physicians visits.

Unlikely to be beneficial.

Defined as contact between a medical professional and a patient not motivated by symptoms and includes screening tests to assess health.

Purpose is to prevent future illness by earlier diagnosis, and to provide reassurance.

Rarely helpful, but associated with unintended consequences.

”Choosing wisely” initiative concludes that the evidence is insufficient to support routine use of annual general health check ups for asymptomatic adults without a specific concern, chronic condition, or evidence-based prevention strategy.

Screen increases diagnoses, and treatments, which may lead side effects and psychological harm.

15 preventive measures: screenings for blood pressure, cholesterol, breast cancer, colon cancer, cervical cancer, osteoporosis, and prostate-specific antigen; screening and counseling for tobacco, obesity, alcohol use, and depression; influenza, zoster, and aspirin use.

What is presently recommended is focused health checks guided by patient-specific risk factors.

Approximately 1/6 of primary care visits and more than one third of ref2242als from primary care doctors to specialists occur for symptoms for which no organic pathology is apparent.

Diagnostic tests for symptoms with low risk of serious illness do not reassure patients, do not decrease their anxiety or resolve their symptoms (Rolfe, A and Burton, C).

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