Evidence map›Paper›PMID 31542745›Full record

Trial reportBMJ open2019

Evaluating the effectiveness of the NHS Health Check programme in South England: a quasi-randomised controlled trial.

Oliver Kennedy, Fangzhong Su, Robert Pears, Emily Walmsley, Paul Roderick

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. Strategies to improve smoking cessation rates in primary care.The Cochrane database of systematic reviews · 2021
    Pooled it
  3. Trial
  4. Article
  5. Article
  6. Review
  7. Article
  8. Review
  9. Article
  10. Observational
  11. Article
  12. Review
  13. NHS Health Checks: an observational study of equity and outcomes 2009-2017.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Oliver KennedyFaculty of Medicine, University of Southampton, Southampton, UK ok4g13@soton.ac.uk.
Fangzhong SuFaculty of Medicine, University of Southampton, Southampton, UK.
Robert PearsPublic Health Directorate, Hampshire County Council, Hampshire, UK.
Emily WalmsleyFaculty of Medicine, University of Southampton, Southampton, UK.
Paul RoderickFaculty of Medicine, University of Southampton, Southampton, UK.
University of Southampton · GBHampshire County Council · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate uptake, risk factor detection and management from the National Health Service (NHS) Health Check (HC).

designThis is a quasi-randomised controlled trial where participants were allocated to five cohorts based on birth year. Four cohorts were invited for an NHS HC between April 2011 and March 2015.

setting151 general practices in Hampshire, England, UK.

participants366 005 participants born 1 April 1940-31 March 1976 eligible for an NHS HC.

interventionNHS HC invitation.

main outcome measuresHC attendance and absolute percentage changes and ORs of (1) detecting cardiovascular disease (CVD) 10-year risk >10% and >20%, smokers, and total cholesterol (TC) >5.5 mmol/L and >7.5 mmol/L; (2) diagnosing hypertension, type 2 diabetes mellitus, chronic kidney disease (CKD) and atrial fibrillation (AF); and (3) new interventions with statins, antihypertensives, antiglycaemics and nicotine replacement therapy (NRT).

resultsHC attendance rose from 12% to 30% between 2011/2012 and 2014/2015 (p<0.001). HC invitation increased detection of CVD risk >10% (2.0%-3.6, p<0.001) and >20% (0.1%-0.6%, p<0.001-0.392), TC >5.5 mmol/L (4.1%-7.0%, p<0.001) and >7.5 mmol/L (0.3%-0.4% p<0.001), hypertension (0.3%-0.6%, p<0.001-0.003), and interventions with statins (0.2%-0.9%, p<0.001-0.017) and antihypertensives (0.1%-0.6%, p<0.001-0.205). There were no consistent differences in detection of smokers, NRT, or diabetes, AF or CKD. Multivariate analyses showed associations between HC invitation and detecting CVD risk >10% (OR 8.01, 95% CI 7.34 to 8.73) and >20% (5.86, 4.83 to 7.10), TC >5.5 mmol/L (3.72, 3.57 to 3.89) and >7.5 mmol/L (2.89, 2.46 to 3.38), and diagnoses of hypertension (1.33, 1.20 to 1.47) and diabetes (1.34, 1.12 to 1.61). OR of CVD risk >10% plus statin and >20% plus statin, respectively, was 2.90 (2.36 to 3.57) and 2.60 (1.92 to 3.52), and for hypertension plus antihypertensive was 1.33 (1.18 to 1.50). There were no associations with AF, CKD, antiglycaemics or NRT. Detection of several risk factors varied inversely by deprivation.

conclusionsHC invitation increased detection of cardiovascular risk factors, but corresponding increases in evidence-based interventions were modest.

Indexed as

General PracticeState MedicineAdultAgedCardiovascular DiseasesCohort StudiesEnglandFemaleHumansMaleMiddle AgedRisk Assessmentcardiovascular risk managementcardiovascular risk screeninghealth checkspopulation screening

Identifiers

PMID31542745
PMCPMC6756325
OpenAlexW2973564872

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.