Defining a rational approach to screening for cardiovascular risk in asymptomatic patients.
Screening for coronary artery disease or for other forms of cardiovascular disease (CVD), is a superficially attractive idea that has been proposed by many cardiovascular experts. However, guidelines panels that employ medical outcomes and evaluation of a full range of benefits, risks, and harms of screening have repeatedly advised against the adoption of screening programs for CVDs. In this commentary, we discuss the limitations of the predictive capacity of selected cardiovascular screening tools. Possible harms and risks of screening tools are also discussed, and the conclusion is reached that available evidence does not provide support for adoption of a strategy of routine screening of asymptomatic people for CVD with available testing tools or devices. More evidence is needed to justify a policy of screening for CVD.
Greenland
Philip
P
Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Lloyd-Jones
Donald
D
D050197:Atherosclerosis / Q000175:diagnosis; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003327:Coronary Disease / Q000175:diagnosis*; D006801:Humans; D011322:Primary Prevention / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity