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RESEARCH AND PRACTICE: Dan Culica, James Rohrer, Marcia Ward, Peter Hilsenrath, and Paul Pomrehn Medical Checkups: Who Does Not Get Them? Am J Public Health 2002; 92: 88-91 [Abstract] [Full text] [PDF]

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Who Really Needs

Harry B McGee   (28 March 2002)

Medical Checkups: Who Really Needs Them?

Harry B McGee   (15 February 2002)

Who Really Needs 28 March 2002
Harry B McGee, Epidemiologist Michigan Dept of Community Health Send letter to journal: Re: Who Really Needs mcgeeh{at}michigan.gov Harry B McGee	The premise of this study seemed to be that a periodic health examination is effective in improving health outcomes. The authors acknowledged that the US Preventive Services Task Force recommendations are specifically based upon age, sex and risk factors. However, they concluded that they could define a typical "lapsed user" as (among other things) a 25-44 year old male who smokes and doesn't exercise, but is otherwise in apparently good health. If these "lapsed users" were to have some kind of periodic routine medical checkup, what evidence is there that they would receive effective clinical preventive services related to smoking and physical activity? Many physically inactive smokers who already contact the medical care system for established routine periodic health examinations, and other reasons, do not receive effective clinical preventive services to address these behaviors. It seems premature to conclude that these "lapsed users" should undergo rountine medical checkups unless they are specifically going to receive effective clinical preventive services aimed at their smoking and physical inactivity. I also suggest that the authors clarify if they really meant to say that poststratification weights were used to correct for selection bias.
Medical Checkups: Who Really Needs Them? 15 February 2002
Harry B McGee, Epidemiologist Michigan Dept of Community Health Send letter to journal: Re: Medical Checkups: Who Really Needs Them? mcgeeh{at}michigan.gov Harry B McGee	The premise of this study seemed to be that a periodic health examination is effective in improving health outcomes. The authors acknowledged that the US Preventive Services Task Force recommendations are specifically based upon age, sex and risk factors. However, they concluded that they could define a typical "lapsed user" as (among other things)a 25-44 year old male who smokes and doesn't exercise, but is otherwise in apparently good health. If these "lapsed users" were to have some kind of periodic routine medical checkup, what evidence is there that they would receive effective clinical preventive services related to smoking and physical activity? Many physically inactive smokers who already contact the medical care system for established routine periodic health examinations, and other reasons, do not receive effective clinical preventive services to address these behaviors. It seems premature to conclude that these "lapsed users" should undergo routine medical checkups unless they are specifically going to receive effective clinical preventive services aimed at their smoking and physical inactivity. The preventive task force recommends counseling for smokers and those who are physically inactive, but they do not recommend routine medical checkups and they do not claim that counseling is effective. I also suggest that the authors clarify if they really meant to day that poststratification weights were used to correct for selection bias.