Abstract

KIE: Mant and Fowler maintain that medical screening of patients often is recommended without consideration of efficacy, feasibility, or ethics. They offer general practitioners four questions to consider before the latter commit their practices to a large-scale screening program, and discuss the theoretical and ethical issues underlying these questions: (1) Can we offer effective treatment for patients positive on testing?; (2) How many positive tests will prove to be false alarms (and is this acceptable)?; (3) How many patients will need follow-up over the next 5 years (and can we sustain this workload)?; and (4) How are we going to audit routinely the quality of the test, of the intervention, and of follow-up?