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Some Pitfalls in Disease Screening

Some Pitfalls in Disease Screening Abstract To the Editor. — Lefebvre and coworkers1 and the accompanying editorial by Havas2 raise several critical and appropriate parallels between screening efforts for hypertension and those for hypercholesterolemia. Al(Continued on p 1124.) (Continued from p 1121.) though their summary of labeling is thoughtful and apt, a few qualifications may be useful and important. The screening effort itself encompasses multiple complexities. The absolute number of individuals undergoing a screening may be less crucial than the number and proportion who were previously unaware of their condition. The hypertension literature3 suggests that many screenees had previously undergone similar screening and wished merely to verify the prior result. Close linkage to follow-up and treatment for sustained elevation represents another hurdle. To minimize unavailability for follow-up, several investigators demonstrated the feasibility of work-site programs, arguing the several advantages of a nearly "captive" audience. Haynes et al4 observed dramatic elevations in illness absenteeism References 1. Lefebvre RC, Hursey KG, Carleton RA. Labeling of participants in high blood pressure screening programs: implications for blood cholesterol screenings . Arch Intern Med . 1988;148: 1993-1997.Crossref 2. Havas S. The challenge of lowering blood cholesterol levels . Arch Intern Med . 1988;148: 1910-1913.Crossref 3. Rudd P, Marton KI. Nontraditional problems of antihypertensive management . West J Med . 1979;131:179-192. 4. Haynes RB, Sackett DL, Taylor DW, Gibson ES, Johnson AL. Increased absenteeism from work after detection and labeling of hypertensive patients . N Engl J Med . 1978;299:741-744.Crossref 5. Rudd P, Price MG, Graham LE, et al. Consequences of worksite hypertension screening: changes in absenteeism . Hypertension . 1987; 10:425-436.Crossref 6. Taylor DW, Haynes RB, Sackett DL, Gibson ES. Long-term follow-up of absenteeism among working men following detection and treatment of their hypertension . Clin Invest Med . 1981;4: 173-177. 7. Charlson ME, Alderman M, Melcher L. Absenteeism and labelling in hypertensive subjects: prevention of an adverse impact in those at high risk . Am J Med . 1982;73:165-170.Crossref 8. Rudd P, Price MG, Graham LE, et al. Consequences of worksite hypertension screening: differential changes in psychosocial function . Am J Med . 1986;80:853-860.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Some Pitfalls in Disease Screening

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Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1990.00390170143037
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. — Lefebvre and coworkers1 and the accompanying editorial by Havas2 raise several critical and appropriate parallels between screening efforts for hypertension and those for hypercholesterolemia. Al(Continued on p 1124.) (Continued from p 1121.) though their summary of labeling is thoughtful and apt, a few qualifications may be useful and important. The screening effort itself encompasses multiple complexities. The absolute number of individuals undergoing a screening may be less crucial than the number and proportion who were previously unaware of their condition. The hypertension literature3 suggests that many screenees had previously undergone similar screening and wished merely to verify the prior result. Close linkage to follow-up and treatment for sustained elevation represents another hurdle. To minimize unavailability for follow-up, several investigators demonstrated the feasibility of work-site programs, arguing the several advantages of a nearly "captive" audience. Haynes et al4 observed dramatic elevations in illness absenteeism References 1. Lefebvre RC, Hursey KG, Carleton RA. Labeling of participants in high blood pressure screening programs: implications for blood cholesterol screenings . Arch Intern Med . 1988;148: 1993-1997.Crossref 2. Havas S. The challenge of lowering blood cholesterol levels . Arch Intern Med . 1988;148: 1910-1913.Crossref 3. Rudd P, Marton KI. Nontraditional problems of antihypertensive management . West J Med . 1979;131:179-192. 4. Haynes RB, Sackett DL, Taylor DW, Gibson ES, Johnson AL. Increased absenteeism from work after detection and labeling of hypertensive patients . N Engl J Med . 1978;299:741-744.Crossref 5. Rudd P, Price MG, Graham LE, et al. Consequences of worksite hypertension screening: changes in absenteeism . Hypertension . 1987; 10:425-436.Crossref 6. Taylor DW, Haynes RB, Sackett DL, Gibson ES. Long-term follow-up of absenteeism among working men following detection and treatment of their hypertension . Clin Invest Med . 1981;4: 173-177. 7. Charlson ME, Alderman M, Melcher L. Absenteeism and labelling in hypertensive subjects: prevention of an adverse impact in those at high risk . Am J Med . 1982;73:165-170.Crossref 8. Rudd P, Price MG, Graham LE, et al. Consequences of worksite hypertension screening: differential changes in psychosocial function . Am J Med . 1986;80:853-860.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: May 1, 1990

References