Berwick D M
JAMA. 1985 Sep 20;254(11):1492-8. doi: 10.1001/jama.254.11.1492.
Health fairs provide multiphasic screening to more than 2 million Americans each year, and the number is growing rapidly. Nearly 40 different tests are in use, commonly including the measurement of up to 30 different blood chemistry levels. This report reviews the activities in a sample of 940 health fair sites and examines the experience regarding six specific screening procedures (blood pressure, anemia, blood chemistries, glaucoma, hearing, and fecal occult blood testing). Widespread use of these and other tests raises complex issues of cost, risk, and benefit. Rates of false alarm of healthy people and false reassurance of those at risk may be high for some tests, and the benefits of detecting new disease are easily overestimated. Detailed data collection and evaluation could help health fair sponsors to identify more rational screening strategies.
健康博览会每年为超过200万美国人提供多项筛查，而且这一数字正在迅速增长。目前使用的检测项目近40种，通常包括多达30种不同血液化学指标的检测。本报告回顾了940个健康博览会站点的样本活动，并考察了六项特定筛查程序（血压、贫血、血液化学、青光眼、听力和粪便潜血检测）的经验。这些检测及其他检测的广泛使用引发了成本､风险和益处等复杂问题。对于某些检测，健康人群的误报率和高危人群的误判率可能很高，而且发现新疾病的益处很容易被高估。详细的数据收集和评估有助于健康博览会主办方确定更合理的筛查策略。
