JAMA Intern Med. Published online June 12, 2018. doi:10.1001/jamainternmed.2018.2773
In 1968, Wilson and Jungner1 outlined the 10 key principles for an ideal screening program. To paraphrase this classic article, a screening program should (1) focus on a common, treatable medical condition; (2) use a suitable, cost-effective test that can accurately detect the condition; and (3) lead to an intervention that can reduce complications of the condition without causing adverse effects by applying the intervention to individuals who will not benefit. Cardiovascular disease (CVD) is a common global problem with effective interventions to mitigate life-threatening complications, particularly in symptomatic patients. However, in asymptomatic patients, interventions, such as revascularization, do not prevent complications. Therefore, our traditional screening tools, namely resting and exercise electrocardiography (ECG), fail to meet the key principles Wilson and Jungner1 described years ago and should force clinicians to ask hard questions about whether asymptomatic patients should ever be screened for CVD./.../
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