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How to prevent and save from the Rashoman" effect in Health care?

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By Dr CSRaju

 How to prevent and save from the Rashomon" effect in Health care?


For 50+ senior citizens, screening should shift from “disease detection” to cardiometabolic risk stratification, cancer surveillance, organ reserve assessment, and functional aging metrics.

Below is a clinically sound, India-relevant 50+ screening protocol:

Core Annual Tests (All ≥50 Years)

1️⃣ Cardiovascular Risk Panel

  • Blood Pressure

  • Fasting Blood Glose / HbA1c

  • Lipid Profile

  • Resting ECG

Purpose: Detect ASCVD risk, silent ischemia, arrhythmia

2️⃣ Renal & Metabolic Panel

  • Serum Creatinine + eGFR

  • Serum Electrolytes

  • Liver Function Test

  • Uric Acid

Purpose: CKD, NAFLD, metabolic dysfunction

3️⃣ Complete Blood Count (CBC)

  • Anemia (common in elderly)

  • Hematologic malignancy red flags

4️⃣ Thyroid Function (TSH)

  • Subclinical hypothyroidism common after 50

  • Impacts cognition, weight, lipids

5️⃣ Vitamin B12 & Vitamin D

  • Neuropathy, cognitive decline

  • Sarcopenia, falls risk

Cancer Screening (Evidence-Based)

Colon Cancer

  • Stool occult blood annually OR colonoscopy every 10 yrs

Cervical Cancer (Women up to 65)

  • Pap smear / HPV test

Breast Cancer

  • Mammography every 1–2 years

Prostate (Men – Risk Discussion)

  • PSA after shared decision-making

Bone & Frailty Assessment

  • DEXA scan (especially women post-menopause)

  • Falls risk assessment

  • Grip strength / mobility

Additional Risk-Based Testing

  • Echocardiography (if hypertensive/diabetic >10 yrs)

  • Carotid Doppler (high ASCVD risk)

  • Low-dose CT chest (heavy smokers)

  • Cognitive screening (MMSE/MoCA if memory complaints)

Vaccination Review (Often Ignored but Critical)

  • Influenza (annual)

  • Pneumococcal

  • Shingles

  • Tdap booster

Below are two structured versions tailored for hospital use in India.

🏥 1) HOSPITAL BROCHURE VERSION

Senior Citizen Health Check – 50+ Comprehensive Care Program

Why After 50?

After 50, the risk of heart disease, diabetes, kidney problems, osteoporosis, and cancers rises significantly. Early detection ensures better quality of life and reduced hospitalizations.

🔬 Core Health Screening Panel

❤️ Heart & Metabolic Health

  • Blood Pressure

  • Fasting Blood Sugar / HbA1c

  • Lipid Profile

  • ECG

🧪 Organ Function Panel

  • Kidney Function (Creatinine, eGFR)

  • Liver Function Test

  • Electrolytes

  • Thyroid (TSH)

🩸 General Health

  • Complete Blood Count (CBC)

  • Vitamin B12

  • Vitamin D

🎗 Cancer Screening

  • Colon Cancer Screening (Stool Occult Blood / Colonoscopy*)

  • Breast Screening (Mammography – Women)

  • Cervical Screening (Pap / HPV – Women up to 65)

  • Prostate Screening (PSA – Men, after doctor consultation)

*As advised by physician

🦴 Bone & Aging Assessment

  • DEXA Scan (Bone Density)

  • Fall Risk Evaluation

  • Frailty Screening

🧠 Cognitive & Lifestyle Review

  • Memory Screening (if needed)

  • Diet & Exercise Counseling

  • Medication Review

  • Vaccination Advisory

🌿 Vaccinations Recommended

  • Influenza (Annual)

  • Pneumococcal

  • Shingles

  • Tdap Booster

Recommended Frequency:

  • Once yearly comprehensive evaluation

  • Physician consultation included

Healthy Aging Starts with Prevention. Book Your Annual 50+ Check Today.


Clinical Strategy for India

After 50, cardiovascular disease + diabetes + cancer account for majority of mortality.
A structured annual panel prevents late-stage presentation.

COST-OPTIMIZED “ESSENTIAL ONLY” PROTOCOL (High-Impact, Budget-Friendly)

Designed for affordability while covering the majority of mortality risk in Indian seniors.

Essential Annual Tests

1️⃣ Blood Pressure
2️⃣ Fasting Blood Sugar or HbA1c
3️⃣ Lipid Profile
4️⃣ Serum Creatinine (eGFR)
5️⃣ Complete Blood Count
6️⃣ ECG

Cancer Screening (Low-Cost Approach)

  • Stool Occult Blood (annual)

  • Clinical Breast Exam (women)

  • Pap Smear (women up to 65)

  • PSA only if symptomatic or high-risk

Optional (If Budget Permits)

  • TSH

  • Vitamin D

  • DEXA (once after menopause / >65 men)



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