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General health checks

This fact box will help you to weigh the benefits and harms of general health checks. The information and numbers are based on the best scientific evidence currently available.

This fact box was developed by the Harding Center for Risk Literacy.

What are general health checks?

General health checks are evaluations of a healthy person’s overall health status. Their purpose is to detect diseases and risk factors for diseases early on in order to reduce the incidence of disease and death in the overall population. General health checks are for people who do not feel ill and who do not show symptoms of a disease [1].

The general health checks that are offered in Germany focus on early detection of cardiovascular and kidney diseases as well as diabetes. This kind of early detection includes:

  • patient–doctor consultation to determine the patient’s medical history and current state of health (anamnesis),
  • a physical examination(e.g. listening to heart and lung sounds with a stethoscope),
  • testing of blood and urine samples,
  • and counseling [2].

Who might consider general health checks?

General health checks are offered once every two years to men and women age 35 onward as part of the statutory health insurance coverage [2].

Fact box_general health checks_EN

What does the fact box show?

The fact box compares the benefits and harms of not participating with those of participating in general health checks.

The table may be read as follows:

About 37 to 38 out of every 1,000 people died of cardiovascular disease, independent of whether they participated in general checks in the space of 4 to 22 years.

The numbers in the fact box are rounded. The data were reported in 14 studies with about 180,000 participants [1].

What other aspects should be considered?

One reason for general health checks not showing any effect could be that (primary care) physicians detect and treat risk factors and diseases they find in their patients during other visits [1].

Most of the included trials are quite dated (1960s to 1980s) andthe results are less applicable to today’s settings because other treatments are now available(e.g. medication for cardiovascular diseases), and risk factors have changed [1].

Do the results provide proof (evidence) for the benefits and harms of general health checks?

Overall, the evidence is of moderate to high quality: Further research is likely to affect the findings on cardiovascular mortality (moderate quality of evidence), while the findings on cancer mortality and overall mortality are very unlikely to be changed in the course of further research (high quality of evidence).

Because the included studies are quite dated, further research is necessary to assess present-day benefits more reliably.

Last update

November 2017

Sources

Information within the fact box was obtained from the following sources:

[1] Krogsboll LT, Jorgensen KJ, Gronhoj Larsen C, et al. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev 2012(10):CD009009.

[2] Gemeinsamer Bundesausschuss. Früherkennungsuntersuchungen im Überblick 2017 [Available from: www.gba.de/institution/themenschwerpunkte/frueherkennung/ueberblick/

Fact boxes

The idea of fact boxes was developed by Lisa Schwartz and Steven Woloshin. In several studies they demonstrated that fact boxes were effective tools for informing the general public about benefits and harms of medical interventions. Read more in the overview.

Technical Terms

It is not always easy to evaluate (health) risks. To facilitate risk comprehension we have summarized and explained technical terms and criteria in a glossary.

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