A systematic review (assessing screening of haemochromatosis) 1 including 2 studies with a total of 409 subjects was abstracted in DARE. The diagnostic studies in the review are not reported here. A retrospective cohort study reported greater estimated Kaplan-Meier survival for patients who were adequately phlebotomised compared with those who were not (93% versus 48% at 5 years, and 78% versus 32% at 10 years), but the clinical comparability of the patient groups could not be determined. A before-and-after study reported improved liver histology in 42 out of 185 patients after phlebotomy (deterioration was reported in 2 patients); biopsy sampling error was a potential concern in this study.
Comment: The authors conclude that given the lack of evidence on the effectiveness of therapeutic phlebotomy, the effectiveness of screening in primary care could not be directly assessed.
Primary/Secondary Keywords