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Cardiovascular risk at health checks performed opportunistically or following an invitation letter. Cohort study

Gulliford, MC; Khoshaba, B; McDermott, L; Cornelius, V; Ashworth, M; Fuller, F; Miller, J; ... Wright, AJ; + view all (2018) Cardiovascular risk at health checks performed opportunistically or following an invitation letter. Cohort study. Journal of Public Health , 40 (2) e151-e156. 10.1093/pubmed/fdx068. Green open access

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Abstract

Background: A population-based programme of health checks has been established in England. Participants receive postal invitations through a population-based call–recall system but health check providers may also offer health checks opportunistically. We compared cardiovascular risk scores for ‘invited’ and ‘opportunistic’ health checks. Methods: Cohort study of all health checks completed at 18 general practices from July 2013 to June 2015. For each general practice, cardiovascular (CVD) risk scores were compared by source of check and pooled using meta-analysis. Effect estimates were compared by gender, age-group, ethnicity and fifths of deprivation. Results: There were 6184 health checks recorded (2280 invited and 3904 opportunistic) with CVD risk scores recorded for 5359 (87%) participants. There were 17.0% of invited checks and 22.2% of opportunistic health checks with CVD risk score ≥10%; a relative increment of 28% (95% confidence interval: 14–44%, P < 0.001). In the most deprived quintile, 15.3% of invited checks and 22.4% of opportunistic checks were associated with elevated CVD risk (adjusted odds ratio: 1.94, 1.37–2.74, P < 0.001). Conclusions: Respondents at health checks performed opportunistically are at higher risk of cardiovascular disease than those participating in response to a standard invitation letter, potentially reducing the effect of uptake inequalities.

Type: Article
Title: Cardiovascular risk at health checks performed opportunistically or following an invitation letter. Cohort study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/pubmed/fdx068
Publisher version: http://doi.org/10.1093/pubmed/fdx068
Language: English
Additional information: Copyright © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: cardiovascular disease prevention, health check, mass screening methods, primary care, social inequalities
URI: http://discovery.ucl.ac.uk/id/eprint/10054060
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