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Jama: How much is the value of medical examination?I’m afraid far beyond your imagination!

Health examination -also known as physical examination -is the second largest common reason for outpatient nursing visits. About 8%of the 900 million outpatient clinics in the United States each year. Almost all insurance companies have covered various medical examination packages through commercial insurance. At the same time, the medical insurance beneficiaries’ annual health visits and other mechanisms provide some or all financial coverage for these visits.

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Although ordinary health examinations are popular in daily clinical care, the value, goals and components of these visits still exist. For example, the Internal Science Association clearly recommends not to conduct annual general health inspections of the symptom -free adults. Other discipline experts have called for these inspections to optimize these inspections so that the team led by doctors can conduct “annual health review” to promote the treatment relationship of trust.

Another source of confusion is the term “annual medical examination”. This is a statement of improper words, because general health checks do not necessarily need to be performed every year, nor does it include physical examinations other than blood pressure and weight index.

Previous studies have different conclusions on the value of general medical examinations. In 2007, a medical research and quality institution (AHRQ) evidence report/technical evaluation and the accompanying review manual found that regular health assessment is consistent with the receiving cancer screening and cholesterol screening, which can reduce patient concerns. However, the impact of regular health assessment on mortality, other clinical results and costs is complicated.

In 2016, COCHRANE’s review of the system risk assessment of first -level prevention of cardiovascular disease found that there was no effect on the mortality or the endpoint of cardiovascular, but there were some evidence that total cholesterol and blood pressure were reduced. In order to better explain the issue, experts from Northwestern University of Ferneberg Medical College conducted a systematic review and were published in Jama magazines.

Researchers have included random trials and control group observation research in the previous system summary and the latest literature review of December 2020. There were 19 random trials (906-59616 participants; 1-30 years follow-up), 5 evaluated single medical examination items, and seven evaluation of annual medical examination items. All 12 studies are observation studies (240-471415 participants; 5 years from horizontal section to 5 years), and evaluate a single medical examination items.

In general, conventional medical examinations have nothing to do with the reduction in the incidence of mortality, cardiovascular events or cardiovascular disease. However, conventional medical examinations are related to the increase in the detection rate of chronic diseases, such as depression and hypertension. Among the people’s 45-64-year-old education level, those who received a medical examination have obtained more new antidepressant prescriptions (2.9 times for the control group).

At the same time, conventional physical examinations can make participants moderately improved in terms of controlling blood pressure and cholesterol: Rural adults 25-74 years old adults have been accepted for 1 year after receiving conventional physical examinations, compared with the systolic blood pressure (low 1.3 mm Hg) and total cholesterol of the unpaid examination. (4.6 mg/dl) are better controlled.

Similarly, regular medical examinations can also receive more clinical prevention services, such as colorectal cancer (69% VS 60%) and cervical cancer (81% vs 66%) to screen; and the patient’s prognosis results have been improved more obvious, such as life, such as life, such as life The health of quality and self -evaluation.

In addition, conventional physical examination is also related to the improvement of health behavior such as physical activity and diet. For example, in the Oxcheck test (n = 4121), the annual medical examination participants have less intervention participants (68% vs 71%), and fewer people who eat butter (22% vs 31%) Essence

It can be seen that conventional medical examinations have nothing to do with the reduction of mortality or cardiovascular events, but it is related to chronic disease identification and treatment, risk factors control, preventive service acquisition and patient prognosis.

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