Whither Multiphasic Screening?

Thorner, Robert M.

doi:10.1056/nejm196905082801904

Cited by 21 publications

(2 citation statements)

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“…Much of the current controversy over multiphasic screening and periodic health examinations can be attributed to the lack of complete acceptr ance by the medical profession of the thesis that a positive contribution to health is made by the detection of early or asymptomatic chronic disease, and an almost total lack of evidence linking this intermediate objective to the "health" of patients (8,9). It is also important to note that acceptance of the health value of many of these activities by the general public is quite different from professional acceptance.…”

Section: Comparative Methods Of Evaluationmentioning

confidence: 99%

Health Program Evaluation in Relation to Health Programing: The Expectation and the Reality

Thorner¹

1971

HSMHA Health Reports

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GOVERNMENT at all levels is expanding its contribution to the payment of health services and medical care costs, both in absolute terms and relative to the total investment in these services (1). With this rising expenditure has come an increasing demand for the rationalization of the expenditure, manifested by greater emphasis on program planning and evaluation. Organizational entities concerned with planning and evaluation exist at almost every echelon of the Federal health establishment, in most State and local units, and in Regional Medical Programs. A section on evaluation has become the sine qua non of every grant application for the support of projects for the development of health or medical care services. Frequently, there is a requirement by grant review groups that evaluation must be "end results evaluation" and go beyond mere counts of activities, services rendered, or the achievement of specified goals to measure the effect of the program or project on the improvement of the health in the community. It is implied, also, that in a rational system the planning of Mr. Thorner is a public health adviser in the

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Section: Comparative Methods Of Evaluationmentioning

confidence: 99%

Health Program Evaluation in Relation to Health Programing: The Expectation and the Reality

Thorner¹

1971

HSMHA Health Reports

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“…Tests are becoming more sophisticated, quantitative and diagnostic; they are also becoming more risk factor oriented, and aimed at primary prevention. Most current programs include elements of both new concepts, and differ from earlier programs concerned only with presumptive identification of asymptomatic disease in presumably well persons (Thorner 1969: 1037).…”

Section: Splintered Timementioning

confidence: 99%

Screening: mapping medicine’s temporal spaces

Armstrong

2012

Sociology Health & Illness

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This paper examines the history of population screening through an analysis of contemporary medical journals. The term was first used in the modern sense in the inter-war years to describe the school health examination which sought to identify the early signs of disease and abnormality, a strategy which was extended to new recruits during the Second World War. After the war, screening began to target those illnesses in the civilian population which had a clear temporal trajectory, especially 'chronic' illnesses. Since the 1980s, enthusiasm for population screening has declined within the medical community: opportunistic screening has seemed more appropriate for diseases with multifactorial aetiology, and those programmes which have survived have been increasingly challenged through an expanding analysis of their potential harms. In identifying the early precursors of clinical disease in apparently normal populations, however, screening heralded the emergence of a new form of clinical practice concerned with the surveillance of 'healthy' patients within the context of new temporal spaces of illness.Keywords: screening, history, time A century or so ago 'screening the patient' would probably have referred to the use of curtains around the patient's hospital bed to provide privacy for a medical procedure. In the 1950s, it marked the brave new world of testing the population for the early stages of disease. Nowadays, it is likely to be a site of contestation over whether it confers benefits or harms. This paper attempts to map these changing uses of the term and the debates which have surrounded its deployment, from its first appearance in the inter-war years of the 20th century, through its period of ascendancy in the post-war years, to its more turbulent history in the early 21st century. In doing so the paper identifies underlying changes in the temporal dimension of illness, of which screening is simply one manifestation.The role of population screening within healthcare has been of interest to doctors, patients, lay groups, lobbyists, and other healthcare professionals, among others, but the analysis in this paper is based primarily on debates within medicine -the relationship with these other discourses is briefly discussed in the final section. Medical engagement with screening was accessed by examining contemporary medical journal articles, editorials and correspondence. Major medical journals are now digitalised and word searchable from their first issues, so they were used to identify when, and in what context, the notion of medical screening was separated from earlier different uses of the term. The subsequent expansion of the use of screening as a routine medical procedure was tracked through a range of medical journals published in both the UK and US supplemented by PubMed searches. Trends were charted in Excel (examples are available in the supplementary files accompanying this paper) and

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Physicians' Use and Opinions of Screening Tests in Ambulatory Practice

Bates¹

1970

JAMA

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Whither Multiphasic Screening?

Cited by 21 publications

References 15 publications

Health Program Evaluation in Relation to Health Programing: The Expectation and the Reality

Health Program Evaluation in Relation to Health Programing: The Expectation and the Reality

Screening: mapping medicine’s temporal spaces

Physicians' Use and Opinions of Screening Tests in Ambulatory Practice

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