PT  - JOURNAL ARTICLE
AU  - A Rouse
AU  - P Adab
TI  - Is population coronary heart disease risk screening justified? A discussion of the National Service Framework for coronary heart disease (Standard 4).
DP  - 2001 Oct 01
TA  - British Journal of General Practice
PG  - 834--837
VI  - 51
IP  - 471
4099  - http://bjgp.org/content/51/471/834.short
4100  - http://bjgp.org/content/51/471/834.full
SO  - Br J Gen Pract2001 Oct 01; 51
AB  - Standard 4 of the National Service Framework (NSF) for coronary heart disease (CHD) describes population cardiovascular risk screening at primary care level. General practitioners (GPs) are expected to deliver this standard and have their performance monitored as part of their clinical governance programme. Although CHD is an important preventable health problem in the United Kingdom (UK), the effectiveness of primary prevention screening programmes are minimal, even within clinical trial settings, and their cost-effectiveness is not clear. The National Screening Committee has identified clear standards for establishing a screening programme in the UK and the activities described in Standard 4 do not fulfill many of these criteria. Specifically, there are no plans for central organisation and co-ordination, no agreed quality assurance standards, and no uniform system for performance management. The clinical, social, and ethical acceptability of the interventions mandated have not been established, and GPs are left to consider how to redirect resources to achieve the standard. We argue that the benefits of population cardiovascular screening must be established through properly conducted trials and, if a programme is introduced, adequate resources and management structures must first be identified.