The ultimate health check...the future is now!


We’re all familiar with the  NHS health check. While it has been instrumental in identifying undiagnosed cardiovascular diseases, it remains a very limited test. There are also -of course- various cancer screening programs that occur at different points of a patient's life in the UK.


As a practicing GP in England, I asked myself what the ultimate test would look like? Let’s engage in some blue-sky thinking and think outside the box for a second. 


Personalisation:


It always starts with good history taking!  You may be familiar with PHE’s ‘How are you quiz’ which entails a comprehensive lifestyle questionnaire which could and should form the basis of our ultimate health check! 


Wearable devices can now allow the measure of our heart rate variability which allows us to measure our levels of stress and physical fitness, and devices like the Beddit allow us to measure our sleep quality.


Let’s now take a look at what’s happening in the market; Several companies in the UK and the USA are pioneering with new tests based on scientific advances, albeit not yet validated by the  MHRA or the FDA. Let’s take a quick look at what they offer



Biological age:


We all age at different rates and it is now established that there is a link between telomere length, DNA methylation and our biological age. Numerous companies have started producing epigenetic testing to measure biological age. MyDNAge, Elysium Index, Chronomics, to name a few. These tests assess our true age and therefore predisposition to disease but they can also serve to measure the impact lifestyle interventions and treatments have on our biological age. In other words biological age, unlike calendar age, is flexible and can be reversed to a certain degree. 


The microbiome:


There isn’t a day without a new paper being published about the link between bacteria that live in our gut and on our skin and chronic diseases that afflict us. The gut bacterium akkermansia muciniphila has been found to impact our risk of diabetes and obesity. Recent studies have demonstrated a direct link between our microbiome and conditions like asthma and atopy. While more research is needed for a better understanding, companies like Viome in the USA  or  Atlas Biomed in the UK are not waiting to commercialise their tests. These are constantly enriched with scientific evidence as it emerges but also use AI to better understand the impact of nutrition on our gut bacterial diversity.


So what should the ultimate health check look like?  


... A combination of evidence-based tests that are cyclical and occur at a variable frequency depending on the patient's specificities. Testing would be holistic in assessing the patient’s baseline by integrating elements of the ‘how am I doing’ test with a measure of biological (rather than calendar) age and objective measures of fitness. It would incorporate research into the microbiome and benefit patients with the latest advances in this field. It would have an easy to read and engaging reporting system with clear lifestyle interventions and treatment options, with a personalised timeline for re-testing. It would also be held within the patient’s record and be accessible to the patient at all times. It would also incorporate all screening programs within one single space, with a clear timeline and reminders.


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