Professional Documents
Culture Documents
22 March 2009
H-Health check ups
Essential components of a
routine health check up Recommended panel of tests
Although common wisdom might
suggest that the more tests ✪ Head-to-toe physical examination
obtained, the greater is the ✪ Body weight, body mass index (BMI), waist and hip
likelihood of picking up disorders circumference measurement
in their early stage, the evidence ✪ Blood pressure
clearly runs counter intuitive. A ✪ For women: Breast examination & Pap smear
routine health check up needs to ✪ Blood sugar – fasting and 2-hour postprandial
include only a limited number of
✪ Lipid profile (cholesterol panel)
simple, inexpensive interventions.
The chart alongside lists them. To date, there is no evidence that additional tests are
Loading the list with more costs of benefit
money but yields no benefit.
TEST WHY?
Resting ECG (Rs 125) False negatives: The ECG can be normal in the presence of
significant coronary artery disease – 25-30% of patients with heart
attacks have had previous normal ECGs.
Stress ECG (Rs 750) False positives: A positive test can occur in the absence of
disease. Stress ECG (treadmill testing) should never be a part of a
routine health check up. It should be ordered, preferably by a
specialist, only after a careful history suggests the presence of
coronary disease.
X-ray chest (Rs 175) Limited value in non-smokers and those without lung problems
like asthma or bronchitis.
Liver function tests (Rs 300) Can be normal in the presence of liver disease.
Lung function tests (Rs 500) Very poor correlation with lung status.
Abdominal ultrasound (Rs 500) Will pick up “abnormalities” of no significance. Ultrasound scans
are not sensitive enough for early diagnosis of many disorders of
the abdomen.
A firm, polite refusal will save Rs 2,500 with no danger to the person