[DavidGordon10]

But Martyn (@14.17) sorry, but what is the evidence that regular blood tests do you or anyone any good? There is no such evidence – as in my original post a couple of days ago. No evidence at all.

Like any form of screening, regular blood tests need evidence that they are dong good rather than harm. They can do harm – you may easily have a false positive result (make a type 1 error, in other nomenclature) and treat it: when it does not need treating.

[transtraxman]

I take advantage of the regular visits to the doctor to look at my blood pressure – stress (this is a killer with no symptoms).

The blood samples I take every six months or so to look at heart problems but other mature male problems – liver, kidneys, prostate, colon and others.

In other words I hope to be able to say to my wife and children before I kick the bucket that I have tried to solve the problems, but when it comes to it if one has to go, then one has to go.

[DavidGordon10]

Yes, transtraxman, blood pressure screening is worthwhile. There is good evidence for it. But blood tests for the other things you mention – no evidence.

For example, screening for prostate cancer by measuring the PSA (prostate specific antigen) hs been around for a long time. A few years ago, back to back papers in the Lancet and the New England Journal of Medicine showed there was no benefit from the screening protocols being used at that time, using measurements of PSA, and some harm.

If you want to be screened for disease of the colon, have the stool tested for blood, or have a screening colonoscopy. Both these have proven value, but no blood test has value as a screning test for disease of the colon.

As I wrote before, it is counterintuitive that screening can be harmful but it often is.

[esselle]

DavidGordon10

I have a 6 monthly review at my GP, and a full scale MOT at BUPA every 12 months. Both pay great attention to reviewing bloods. Are you saying I am wasting my time?

[DavidGordon10]

Esselle – generally speaking, yes.

This is a huge subject with an extensive and heavily technical literature! Some things are well worth doing (blood pressure; sugar in the urine), some things are positively not worth doing (screening blood tests of liver or kidneys) and others are highly debatable: for example, mammography.

If you have any symptoms, or any relevant history, then the position changes. If you drink too much of the hard stuff, for example, it is worth having your biochemical liver function tests done.

Screening for cancer of the female breast is a good example. It used to be considered good practice for the doctor to check the breasts of a patient who was in the clinic for another reason, feeling for abnormal lumps in the breast. Then the evidence showed that this is, actually, not effective in detecting otherwise unsuspected disease. So we now teach medical students that they should not routinely check the female breast for lumps.

[DavidGordon10]

As I have said before, it is counterintuitive. I once had to explain to a scientist who had won the Nobel prize that his idea of an annual whole-body MRI scan was a bad one!

[transtraxman]

DavidGordon10@

Despite your advice/warning if I can get get the said blood/urine tests for free or all at the same price I will continue to do it. My doctors recommend it and until shown otherwise I will continue to follow the advice of the six or so professionals who have looked after me for so long. Time will tell.

[MartynSinclair]

DavidGordon10 – in 2007 following an abnormal ECG, I was referred to a cardiologist, which resulted in a angiogram, within 24 hours and suspension of my aviation medical (subsequently lifted)

Was recommended Aspirin and Statins (this was 2007), but asked whether I could change diet / lifestyle to avoid medication and was given 3 months to change.

Cardiologist agreed and took blood 3 months later and along with the weight loss, agreed not to put me on any medication.

He still reviews my blood tests and compares to previous data and is able to tell by comparing test results, what is going on in terms of vitamins lacking or problems in the offing.

I am very much aware that it is not a 100% solution to health screening, BUT it does go along way to warn the DR’s of impending problems…..

If you have more interesting solutions to health care screening and take on private patients, I would gladly make an appointment…

Main objective is to keep fit, especially when travelling…..

[DavidGordon10]

Dear Martyn – you are a very good example of one point I was making in my 15.15 post: you have a medical history, and your investigations and treatment are exactly right, and I am very pleased at such a good outcome.

They are not what I think of as screening, by which I mean the investigation (physical examination, blood tests, scans, Xrays and so on) of persons who do not have symtoms or a history that needs to be looked in to. Screening without symtoms or signs that need investigation does only limited good, and can do harm. But, as I said before, I am very pleased (for example) to have the screening investigations for bowel cancer, because there is evidence that they do good without doing harm.

[Tim2soza]

Professor Robert Thomas’ article is worth a read.

[LuganoPirate]

This is very interesting especially hearing DavidGordon’s opinion, and I fully accept what he says. However, I don’t quite see how taking a blood sample and analysing it can do any harm. I accept you can have the all clear today, and go down with some deadly disease tomorrow but from a personal perspective it gives me peace of mind and I think having peace of mind is half the battle won!

As an aside, I’m not exactly the fittest man on the planet, nor the smallest come to that, but my slim and fit doctor was annoyed (in a nice way) that my results, including blood pressure, were much better than his!

[Author]

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