为了证明NHS健康检查计划的合理性,需要哪些证据?
Karsten Juhl Jørgensen1,2, Minna Johansson3,4, Steven Woloshin5,4
1Cochrane Denmark and Centre for Evidence-Based Medicine Odense, University of Southern Denmark, Odense, Denmark. kj@cochrane.dk.
BMC medicine
|April 24, 2025
概括
根据NHS健康检查计划,总死亡率没有降低,这与观察的说法相矛盾. 随机试验的证据表明没有显著的益处,质疑该计划对公共健康的价值.
科学领域:
- 公共卫生 公共卫生
- 预防医学 预防医学
- 卫生政策 卫生政策
背景情况:
- 国家卫生健康检查计划旨在减少大量人口的死亡率和疾病发病率.
- 一项观察性研究报告了总死亡率和肝硬化发病率的显著降低.
- 有关该计划的好处,危害,成本和证据基础存在担忧.
研究的目的:
- 批判性地评估NHS健康检查计划所声称的好处.
- 将观察性研究的结果与随机对照试验的证据进行比较.
- 评估该计划是否与基于证据的医学和查指南保持一致.
主要方法:
- 对NHS健康检查组件的11项高质量随机试验的系统审查和元分析.
- 分析了233,298名参与者和21,535人死于这些试验.
- 随机试验数据与来自特定观察研究的说法进行比较.
主要成果:
- 随机试验显示,总死亡率的风险比为1.00 (95% CI为0.97至1.03),表明没有显著影响.
- 该计划对包括心血管疾病在内的向疾病的死亡率几乎没有影响.
- 观察性研究的结果没有得到随机试验证据的支持,也没有解决危害问题.
结论:
- "NHS健康检查计划不符合英国国家查委员会的要求,证明好处超过危害.
- 优先考虑观察数据而不是相互矛盾的随机试验,忽视评估危害,这与科学原则相反.
- 建议英国国家查委员会审查NHS健康检查计划.
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