Participation in health check-ups and mortality using propensity score matched cohort analyses.
Summary of "Participation in health check-ups and mortality using propensity score matched cohort analyses."
OBJECTIVE:
All Japanese aged≥40years are eligible for free annual health check-ups including blood pressure and cholesterol measurements. It is well known that health check-up screenees are more likely to have healthy lifestyles and better health conditions than non-screenees. Therefore, controlling these factors is required to investigate whether screenees have a lower mortality risk than non-screenees independent of their lifestyles or health conditions.
METHODS:
We followed 48,775 Japanese National Health Insurance beneficiaries aged 40-79years at 1994 for 11years. We used Cox proportional hazard models adjusted for possible confounding factors. We also performed propensity for use of the health check-up matched cohort analyses.
RESULTS:
Compared with non-screenees, multiple-adjusted hazard ratios (95% confidence intervals) for all-cause and cardiovascular disease mortality among screenees were 0.74 (0.62-0.88) and 0.65 (0.44-0.95) for men and 0.69 (0.52-0.91) and 0.61 (0.36-1.04) for women, respectively. These relations were also observed when we used propensity matched cohort analyses.
CONCLUSION:
This is the first study to show that mortality rates are lower among screenees than non-screenees in Japanese health check-ups when propensity matched cohort analyses were used for adjusting confounding factors. Further prospective studies, including randomized controlled trials, are required to confirm whether screening lowers mortality.
Affiliation
Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Public Health, Yamagata University Graduate School of Medical Science, Yamagata, Japan.
Journal Details
This article was published in the following journal.
Name: Preventive medicine
ISSN: 1096-0260
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20828583
- DOI: http://dx.doi.org/10.1016/j.ypmed.2010.08.017
Medical and Biotech [MESH] Definitions
Propensity Score
Conditional probability of exposure to a treatment given observed covariates.
Injury Severity Score
An anatomic severity scale based on the Abbreviated Injury Scale (AIS) and developed specifically to score multiple traumatic injuries. It has been used as a predictor of mortality.
Apgar Score
A method, developed by Dr. Virginia Apgar, to evaluate a newborn's adjustment to extrauterine life. Five items - heart rate, respiratory effort, muscle tone, reflex irritability, and color - are evaluated 60 seconds after birth and again five minutes later on a scale from 0-2, 0 being the lowest, 2 being normal. The five numbers are added for the Apgar score. A score of 0-3 represents severe distress, 4-7 indicates moderate distress, and a score of 7-10 predicts an absence of difficulty in adjusting to extrauterine life.
Health Status Indicators
The measurement of the health status for a given population using a variety of indices, including morbidity, mortality, and available health resources.
Health Transition
Demographic and epidemiologic changes that have occurred in the last five decades in many developing countries and that are characterized by major growth in the number and proportion of middle-aged and elderly persons and in the frequency of the diseases that occur in these age groups. The health transition is the result of efforts to improve maternal and child health via primary care and outreach services and such efforts have been responsible for a decrease in the birth rate; reduced maternal mortality; improved preventive services; reduced infant mortality, and the increased life expectancy that defines the transition. (From Ann Intern Med 1992 Mar 15;116(6):499-504)
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