An Evaluation of the Periodic Health Examination:

Publisher Website
Google Scholar
Abstract
Of 350 deaths occurring in people periodically examined at 10 different clinics, 181 were due to coronary heart disease. In only 58% of these was the disease diagnosed on or before the last examina -tion. A study of the routine procedures carried out on these people was made in order to determine which procedures, if any, discriminated between these people and matched living counterparts. When all coronary deaths were compared with their living counterparts the procedures which differentiated best between the 2 groups were in general those upon which the diagnosis of heart disease is commonly made (EKG, pain in chest, hypertension, dyspnea and abnormal cardiovascular findings on chest X-ray). When, however, those persons in whom a diagnosis of coronary heart had been made, were selected for comparison, half of whom died and half of whom survived, the majority of the signs on which the diagnosis is commonly made were not helpful in distinguishing between death and survival. In this situation the best discriminatory factors were chest pain and elevation of diastolic pressure. No characteristics differentiated effectively between people who died of undetected heart disease and their living counterparts supposedly free of heart disease. Heavy cigarette smoking was the only reasonably effective discriminating factor. In general, characteristics regarded as risk factors for coronary heart disease were not helpful in assessing the lethal quality of the disease once it was established.

This publication has 1 reference indexed in Scilit: