Seeing the need to establish guidelines for diagnostic testing and limit its cost, a program on diagnostic testing was launched recently by nine task forces covering different areas of health care. The “Philippine Guidelines for Periodic Health Examinations (PHEX): Effective Screening among apparently Healthy Filipinos.” PHEX is now set to be the rule in conducting periodic health examinations for Filipino patients.

Dr. Dante Morales, editor of the PHEX, said  the project took four years to gather pertinent data and synthesize them. Based on the burden of disease, accuracy of the tests, availability of treatment, and cost-effectiveness data, evidence-based recommendations were finalized after several organizational and multi-sectoral meetings.

“The Canadian Task Force on periodic health examinations in 1984 and the U.S preventive services task force in 1984 prepared landmark reports, which served as foremost sources of information in the development of annual physical examination or executive check- up package. We studied and adopted that and we found out that adopting those  guidelines would reduce health examinations almost by half. This would largely help those with limited resources.”

Dr. Morales stressed that the PHEX would  limit the kind of testing that a patient should undergo to avoid being ‘falsely labeled’ or being ‘falsely positive.’

“If a test was done but  is not specific, then the doctor might misinterpret the result as a certain disease. Sometimes, the more tests you do, the more abnormalities you will seem to have. It’s almost like you’re not normal because you’re undergoing too many tests. With that, the patient may be labeled as ‘falsely positive.’ This means that the test may be positive, but in reality, the patient is not really sick. They may be given treatments that may not be appropriate.”

The PHEX enlists guidelines for screening tests for the general population, and for the selected population or those who have diseases or may have risk factors for certain diseases. It  includes guidelines for screening tests for pregnant women and patients who undergo routine physical examination. All these seek to ensure that appropriate tests will be carried out for specific individuals.

The development of the PHEX is a concerted effort of 43 schools, hospitals, governments, and non-governmental organizations, 63 researchers, 117 content experts, and 126 stakeholders. It was largely prepared by the Philippine Clinical Epidemiology Network and the Philippine College of Physicians.