title: [General health checks and individual out-of-pocket health services].
abstract: General health checks are intended to identify risk factors or detect early signs of disease and to reduce mortality and morbidity from the disease by early interventions. Screening tests are not always beneficial; therefore, they have to be critically assessed with respect to the benefits and harms. Especially for general health checks there seems to be less awareness for potential harms than for other screening procedures because the diagnostic interventions are mostly less invasive and have low-risks of direct harms, such as ultrasonography or electrocardiography (ECG). Healthcare providers increasingly offer screening tests as individual out-of-pocket health services (Individuelle Gesundheits-Leistungen, IGeL) to patients without providing comprehensive information about the benefits and harms which would be necessary to enable informed decision-making. The article describes the current evidence and the methodological issues in the benefit assessment of general health checks in order to encourage a critical discussion on screening tests.
authors.affiliation: Evidenzbasierte Medizin, Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassen e. V. (MDS), Theodor-Althoff-Str. 47, 45133, Essen, Deutschland. m.eikermann@mds-ev.de.
authors.forename: M
authors.initials: M
authors.lastname: Eikermann
mesh_terms: D003955:Diagnostic Tests, Routine / Q000191:economics* / Q000379:methods*; D042241:Early Diagnosis; D019317:Evidence-Based Medicine; D005858:Germany; D005102:Health Expenditures; D008403:Mass Screening / Q000379:methods*; D010808:Physical Examination / Q000191:economics* / Q000379:methods*; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity
keywords: Chronic disease; Early detection of disease; Evidence based medicine; Informed consent; Screening