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A controlled trial of multiphasic screening.

A clinical controlled trial was designed to determine the impact of Automated Multiphasic Health Testing on morbidity and attitudes. Three strata comprising 574 families (lower-income group enrolled in health maintenance organization, lower-income not enrolled in such a project, and a middle-income group employed by a utility company) were interviewed to obtain information on utilization, morbidity, health status, and attitudes. Sixty percent of adults in each stratum were then screened. All families were interviewed again one year later. The only significant difference found between screened and non-screened subjects was an increase in nights hospitalized for screened subjects. Physicians were interviewed to determine what abnormalities were found and what treatment was required for project and privately referred patients of these physicians. Previously unknown abnormalities prompted retesting for confirmation in only 28 per cent of the cases and even less often led to treatment.

Adolescent

A multiphasic screening programme at the health centre level: the Säkylä-Köyliö project.

The Säkylä-Köyliö Project concerned the investigation and evaluation of different screening programmes and the possibilities for providing the necessary treatment and follow-up at the health centre level. The variables studied consisted of anaemia, bacteriuria, high blood pressure, and mental health problems; an epidemiologic screening for sight and hearing defects and diseases of the musculoskeletal system was carried out as well. The use of health services, together with the relationships between objectively and subjectively determined morbidity, was also studied. A total of 2268 inhabitants of the municipalities of Säkylä and Köyliö, i.e. 93.2% of the 40- to 64-year-old female population and 93.4% of the males in the same age range, participated in the screening programme conducted by the Säkylä-Köyliö Project between 9 September 1973 and 11 January 1974. Only one-fifth (1.9%) of the non-respondents to the first invitation (8.6%) participated in the screening programme after they received a second invitation. This result demonstrates that those who do not participate for some reason cannot, to any great extent, be influenced by a renewed invitation. Since the non-participation rate was insignificant, the material examined may, from the epidemiologic point of view, be considered as representative of the middle-aged population of the two municipalities, which together form a health centre district in Southwest Finland. The high participation percentage also shows that the prerequisite of screening, namely, a positive attitude on the part of the population, was as well fulfilled in the present project.

Adult

Range of frontal plane QRS axes. Electrocardiograms of subjects in a multiphasic screening program.

The range of mean QRS axes in the frontal plane was determined in electrocardiograms of subjects examined in a program of periodic health screening. Fifty-three of 5,163 individuals had a mean frontal QRS axis between -30 degrees and -60 degrees. Fourteen individuals had an axis between +110 degrees and +133 degrees. These findings suggest that individuals with no history of heart disease may manifest a considerable range of frontal plane QRS axes often to a degree previously considered abnormal. The axes were calculated by the use of leads 1 and 3. Other leads, or the use of the method of Grant, would give different results. Comparison of series of patients can be made only if these variables are understood.

Adolescent

Plasma fibrinogen, cholinesterase activity, and anemia: utility of fibrinogen in multiphasic screening and in assessing the activity of diseases.

I present the general pattern relationship between (a) plasma fibrinogen and cholinesterase activity and (b) plasma fibrinogen and hemoglobin, in 250 and 310 hospitalized adults, respectively. Although responses of cholinesterase were often unrelated to fibrinogen, when its activity in plasma was depressed, above-normal fibrinogen concentrations were present in about 90% of the subjects. Further, despite the observed independence of hemoglobin and fibrinogen concentrations, whenever frank anemia was present (hemoglobin less than 110 to 120 g/liter), hyperfibrinogenemia was also present in about 75-85% of such anemic patients. Thus, these studies affirm that fibrinogen determination would be an appropriate component of tests on hospital admission and also that hyperfibrinogenemia is a very sensitive "acute phase" reactant, and an important reaction for gauging the course of numerous disorders.

Acute Disease

[A study of smoking cessation education in a multiphasic screening setting].

A study of the effectiveness of individual anti-smoking advice was conducted on male smokers visiting a human dock. The intervention group (169 male smokers) were shown photographs depicting the health hazards of smoking with an explanation by tape recorder and headphone. Controls (187 male smokers) did not receive this instruction. In the intervention group, immediately after the instruction, and in the control group, approximately 60% expressed a desire to stop or decrease their smoking. Six months later there was no significant difference in the two groups in the proportion that stated that they were not smoking (8.9% in the intervention group and 5.9% in the control group). Some subgroups in the intervention group, such as those whose smoking index was less than 400 and those who had attempted to quit smoking in the past, had significantly higher quit rates than corresponding subgroups in the controls. Smokers who restricted their smoking in certain locations such as public areas had high quit rates in both groups. Standardized quit rates were utilized, adjusted for current age, age of smoking initiation, smoking index and past experience in smoking cessation. Immediately after receiving the education, the proportion that regarded smoking as a risk factor in gastric cancer, gastric ulcer, chronic bronchitis and as having a harmful effect on the fetus, was significantly larger in the intervention group (about 50-70%) than in the controls (about 30-60%). More than 90% of each group regarded it as a risk factor in lung cancer, and about 60% in myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Results of multiphasic oncology screening of the population in the community of Beĕj 1986-1987. II. Questionnaire screening].

In the framework of the multiphase oncologic population screening in the community of Becej in the period from 1986-1987, the inquiry screening comprised 16,895 persons, whereby the following results were obtained: two malignant breast neoplasms, one uterine corpus neoplasm, one carcinoma of the larynx, and out of the non-target locations, not included in the specific questionnaire, there was one carcinoma of the lower lip and one malignant neoplasm of the salivary gland. Besides, 10 benign breast neoplasms and 12 benign uterine neoplasms were also detected. These specific results lagged behind the expected ones on the basis of the known average incidence and mortality in locations of Vojvodina included by this questionnaire. The elucidation of all possible causes leading to this disaccordance, was the task of specific studies intended for the improvement of this questionnaire as a method for the early detection of malignant and premalignant lesions. Other numerous mass pathological states were detected during the screening of either the characteristic signs of specific malignant neoplasm locations, or of risk factors of particular importance for the appearances of these malignant neoplasms. These health problems with clarified epidemiological dimensions in the population studied, necessitated planned solution according to the accepted doctrinary principals (protocols). Data on these diseases gave new dimensions to the inquiry (and the overall multiphase) oncologic population screening. The target-health educational effect of this inquiry which reached every man over 40 years of age in the population studied should not be neglected, either.

Female