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At least 19 recordsLinked to original sources
PubMed1981

Cost effectiveness of multiphasic screening: old controversies and a new rationale.

The cost effectiveness of multiphasic screening is evaluated from a conceptual as well as from a practical viewpoint. Conceptual analysis includes a consideration of the technical sensitivity and specificity of the tests used, of the prevalences of the screened diseases, and of the costs and values associated with different outcomes of screening. Practical considerations include the potential of multiphasic screening for increasing productivity, for reassuring patients, and for reducing morbidity and mortality. Although all these issues can be cogently formulated, at present none can be documented by a comprehensive set of data leading to irrefutable conclusions. Therefore, the issue of who should be screened continues to be obfuscated by controversy and prejudice. To resolve this dilemma a new rationale for the use of multiphasic screening is developed. This is based on a small number of uncontroversial facts and leads to practical proposals relating to how standards for useful test batteries can be constructed.

Clinical Laboratory Techniques↗
PubMed1977

Multiphasic screening. Case-finding tool in a Teaching Hospital Medical Clinic.

Multiphasic screening as a case-finding tool was evaluated in a randomized, controlled study. For each of 112 physicians, a patient was assigned to one of three groups: multiphasic screening group (SG), chart abstract group (AG), or chart review group (RG). Medical problem lists constructed before and after receiving additional information were compared. Physicians for 36 SG patients identified considerably more new medical problems, both total (77) and ones they considered important (25), than 40 AG physicians (14 and 8) and 36 RG physicians (4 and 0). One year later, 38 of the 95 newly identified problems had been acted on, 31 in the SG. Medical care was affected in nine patients: six in SG, two in AG, and one in RG. Multiphasic screening may help physicians identify new medical problems in clinic patients.

Adult↗
PubMed1975

[Methods and specificity of internal medicine specialties in multiphasic screening].

Issuing from the classical definitions for the diagnostic sensitivity and specifity of examination methods in multiphasic screenings is deduced that out of the whole methodical spectre of internal specialities only limited parts are to be applied in multiphasic screenings. At the instance of a multiple multiphasic screenings (model study Sternberg '70) ways to the establishment of reduced optimal parameter combinations are demonstrated. With multivariate statistical methods (facotor analysis, discriminative methods) we succeeded in finding parameter combinations for special groups of diagnosis (liver diseases, hypertension and obesity), by means which these groups in multiphasic screenings are clearly to be differentiated from the healthy symptom-free residual population.

Cardiovascular Diseases↗
PubMed1967

Advances in multiphasic screening and testing.

The multiphasic testing center of the future will probably be used both for periodic screening tests and for referrals by practicing physicians. Recent widespread interest of several branches of the Federal Government in multiphasic screening stems from the possibility that, through its use, the enormous cost of chronic illness to the country may be reduced.Recent advances in automation and the storage, retrieval, and analysis of data by computers make it economically feasible to obtain much more information about the patient's health than ever before. New instrument developments include both screening and diagnostic analysis of electrocardiograms by computers, analysis of heart sounds by computer, and a wide variety of other physiological and biochemical instruments. To allow for the inclusion and evaluation of these new procedures, a number of multiphasic testing centers will be needed which can do both research and routine testing. Close cooperation between the medical profession, the public health services and industry will be needed to best serve both the public and the medical profession.

Humans↗
PubMedDate not supplied

Multiphasic screening in middle age: results and implications of a controlled trial in British general practice.

The Southeast London Screening Study was designed as a long-term controlled trial of multiphasic screening directed at middle-aged individuals registered with their family doctors. In 1967, 7,229 subjects, aged 40 to 64 years, were randomly allocated into either a screening or control group. The screening group was invited to attend two screening sessions held about two years apart while the control group continued to receive conventional medical care. Both groups were then invited to participate in a health survey in 1972 to 1973. Screening-control comparisons revealed no significant differences in either mortality or morbidity over the first nine years of the study with one exception: the screened males were significantly less "anxious" (as measured by the Middlesex Hospital Questionnaire) than the controls (P less than 0.01). In the context of other negative psychiatric findings, however, the importance of this result is considered doubtful. Despite methodological limitations, it is concluded that multiphasic screening of the middle-aged in general practice is probably not worthwhile.

Adult↗
PubMed1975

Two-step electrocardiogram for chest pain reported on multiphasic screening.

Among 264 consecutive persons (142 men, 122 women) greater than or equal to 35 years of age presenting for multiphasic screening examination, 85 (54 men, 31 women) reported chest pain. In most, the pain was not typical of coronary artery disease. The two-step exercise electrocardiogram (ECG) was positive (greater than or equal to 0.5-mm ischemic ST depression) in 21% of the patients who reported pain and in 19.5% of 66 randomly selected, similarly examined controls without chest pain (36 men, 30 women) (difference not significant). Females with positive ECGs (5-mm or 1-mm depression) predominated over males greater than or equal to 5:1 in the chest pain group and greater than 3:1 in controls. This study indicates that the routine two-step exercise ECG is not helpful in detecting ischemic heart disease in persons reporting chest pain during their multiphasic screening examination.

Adult↗
PubMed2001

A controlled trial of multiphasic screening in middle-age: results of the South-East London Screening Study. 1977.

South-East London Screening Study Group (Department of Community Medicine, St Thomas's Hospital and Medical School, London SE1 1EH, England). A controlled trial of multiphasic screening in middle-age: results of the South-East London Screening Study. International Journal of Epidemiology 1977;6:357-63. The results of a controlled trial of multiphasic screening in general practice are presented. In 1967, 7229 individuals aged between 40 and 64 years were randomly allocated into either a Screening or Control group. The Screening group were invited to attend two screening sessions held about two years apart, while the Control group continued to receive conventional medical care. Both groups were then invited to undergo a health survey in 1972-73 which revealed no significant differences in morbidity between the two groups. Careful follow-up permitted detailed Screening-Control comparisons of various outcome measures-consultation and hospital admission rates, certified sickness absence from work, and mortality. Nine years after the initial screening, no significant differences were found between the two groups in any of the outcome measures. It is estimated that a similar screening programme for the entire middle-aged UK population would cost 142 million pounds at 1976 prices.

Adult↗