Screening Echocardiography Not Beneficial
Am Fam Physician. 2014 Feb 1;89(3):224.
Does screening for heart disease with echocardiography decrease mortality, myocardial infarction risk, or stroke risk?
Population-based screening for heart disease or valve disease with echocardiography will identify cardiac pathology in patients but does not decrease mortality, myocardial infarction risk, or stroke risk. (Level of Evidence = 1b)
In 1994 and 1995, researchers enrolled 6,861 middle-aged (average age = 60 years) inhabitants of a single city (Tromsø, Norway). The participants were randomly assigned, concealed allocation unknown, to a onetime screening for heart disease using two-dimensional echocardiography or to no screening. Participants in both groups were white and evenly split by sex. Approximately 12% of patients self-reported coronary heart disease, 59% had hypertension (although only 13.5% were treated with medication), 32% smoked, and only 4% had diabetes mellitus. Screening identified 7.6% of patients with cardiac or valvular conditions, who were then treated. Over 15 years of follow-up, 26.9% of the participants in the screening group died, compared with 27.6% in the control group (not significant). Similarly, there was no effect of screening on rates of sudden death, mortality from heart disease, or incidence of fatal or nonfatal myocardial infarction and stroke.
Study design: Randomized controlled trial (nonblinded)
Funding source: Unknown/not stated
Referecne: Lindekleiv H, Løchen ML, Mathiesen EB, Njølstad I, Wilsgaard T, Schirmer H. Echocardiographic screening of the general population and long-term survival: a randomized clinical study. JAMA Intern Med. 2013; 173( 17): 1592– 1598.
POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.
For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.
To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for "Poem of the Week" or go to http://goo.gl/3niWXb.
Want to use this article elsewhere? Get Permissions
More in AFP
MOST RECENT ISSUE
Dec 15, 2018
Access the latest issue of American Family Physician