US doctors and public favour annual check ups
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《英国医生杂志》
Most primary care doctors in the United States and their patients want annual physical examinations to screen for asymptomatic problems, a study has found. However, evidence based guidelines from national organisations recommend a more selective approach. Primary care doctors also say that annual check ups may build a relationship.
A study published in the Archives of Internal Medicine (2005;165:1347-52) found that two thirds of doctors in internal medicine, family practice, and obstetrics and gynaecology thought an annual check up was necessary and that 88% perform such examinations.
More than 90% of primary care doctors said that an annual check up provided time to counsel patients about prevention and that it improved doctor-patient relationships. Most also thought it detected subclinical illness and was desired by patients. A previous study by the same group found that nearly two thirds of the public in the same geographical areas wanted annual checkups with extensive testing (Ann Intern Med 2002;136:652-9).
Allan Prochazka, professor of internal medicine at the University of Colorado School of Medicine, and colleagues at the Denver Veterans Affairs Medical Center posted the survey to 1679 doctors in the metropolitan areas of Boston, Denver, and San Diego. They received 783 responses (47%).
The annual check up is a US tradition that has been promoted since 1861. Dr Prochazka said, "It抯 part of the culture in the United States ?Patients feel 慖 want my doctor to be on the lookout for me, to identify things before they become serious.?From the patients?side, it抯 100% understandable. From the doctors?side, a high percentage are in favour, responding to what patients want ?My take is that testing should be individualised and tailored. It should be targeted to the 慴ig ticket?problems: cardiovascular disease, hypertension, diabetes, the major cancers, but individualised based on family history."
National guidelines recommend cervical smear tests, mammography, lipid testing, and measurement of blood pressure, height, and weight. However, the typical annual check up also includes tests—such as complete blood cell count and tests of kidney, liver, and thyroid function—for which data are insufficient to show a benefit and which therefore are not covered by national guidelines.(Janice Hopkins Tanne)
A study published in the Archives of Internal Medicine (2005;165:1347-52) found that two thirds of doctors in internal medicine, family practice, and obstetrics and gynaecology thought an annual check up was necessary and that 88% perform such examinations.
More than 90% of primary care doctors said that an annual check up provided time to counsel patients about prevention and that it improved doctor-patient relationships. Most also thought it detected subclinical illness and was desired by patients. A previous study by the same group found that nearly two thirds of the public in the same geographical areas wanted annual checkups with extensive testing (Ann Intern Med 2002;136:652-9).
Allan Prochazka, professor of internal medicine at the University of Colorado School of Medicine, and colleagues at the Denver Veterans Affairs Medical Center posted the survey to 1679 doctors in the metropolitan areas of Boston, Denver, and San Diego. They received 783 responses (47%).
The annual check up is a US tradition that has been promoted since 1861. Dr Prochazka said, "It抯 part of the culture in the United States ?Patients feel 慖 want my doctor to be on the lookout for me, to identify things before they become serious.?From the patients?side, it抯 100% understandable. From the doctors?side, a high percentage are in favour, responding to what patients want ?My take is that testing should be individualised and tailored. It should be targeted to the 慴ig ticket?problems: cardiovascular disease, hypertension, diabetes, the major cancers, but individualised based on family history."
National guidelines recommend cervical smear tests, mammography, lipid testing, and measurement of blood pressure, height, and weight. However, the typical annual check up also includes tests—such as complete blood cell count and tests of kidney, liver, and thyroid function—for which data are insufficient to show a benefit and which therefore are not covered by national guidelines.(Janice Hopkins Tanne)