Evidence, explained.
Articles on check-ups, biomarkers, screening and longevity science. Each one says what the studies show, how strong the evidence is, and what remains open.
Abdominal aortic aneurysm: the one-time scan for men over 65
A five-minute ultrasound finds a silent killer. What screening men at 65 achieves per 1,000, why women are excluded, and why newer Danish data have reopened the debate.
EvidenceAbsolute vs relative risk: why “halves the risk” can mean little
A drug that cuts risk by 44% may help one person in 170 per year. How to turn headline percentages into numbers that matter for you.
CardiovascularDaily aspirin: how medicine reversed itself
Three trials in 2018 and a 2022 guideline update ended routine aspirin for healthy people. Why bleeding outweighs benefit — and why patients with heart disease should keep taking it.
A surgeon's viewSilent gallstones: why the best operation is often no operation
Most gallstones found by chance never cause trouble. What German and European guidelines advise, the few exceptions, and which symptoms really count.
CardiovascularBlood pressure: the most important number you can measure at home
Every 5 mmHg lower systolic pressure means about 10% fewer major cardiovascular events. How to measure correctly at home, and what the 2024 ESC guideline changed.
OncologyMammography screening: the honest numbers per 1,000 women
Mammography prevents 3 to 8 breast cancer deaths per 1,000 women over 25 years, and causes 11 to 15 overdiagnoses. Germany's programme, dense breasts, BRCA and the move to 45.
MetabolicGlucose monitors for healthy people: data without a diagnosis
Healthy people spend about 96% of the day between 70 and 140 mg/dL — and still see spikes. Why a CGM rarely helps if you don't have diabetes.
LongevityConsumer DNA tests and polygenic scores: what your genome can and cannot tell you
A consumer BRCA test may check just 3 of over 1,000 harmful variants, and 40% of raw-data findings sent for confirmation were false. What genetics really adds.
A surgeon's viewIncidental findings in liver, kidney and adrenal: when to look closer
Scans often find harmless lumps and cysts nobody was looking for. Which findings need work-up, which can be left alone, and how to avoid a cascade of tests.
MetabolicKidney function: why you need two numbers, not one
eGFR from blood and albumin from urine: the two tests that detect chronic kidney disease years early. Most at-risk patients in Germany never get the second one.
A surgeon's viewOrgan donation: decide for yourself, either way
How organ donation works in Germany, why age rarely rules you out, what donation after circulatory death is, and what the Bundestag is debating on opt-out.
EvidenceLead-time bias and overdiagnosis: why survival statistics mislead
Five-year survival can soar while not a single life is saved. Lead time, length time and overdiagnosis explained — and why mortality is the number that counts.
EvidenceHow to read health news: eight questions to ask
Coffee saves lives, coffee harms the heart — one week apart. Eight questions that separate a meaningful study from a misleading headline.
DermatologySkin cancer apps and AI: a second opinion you should not rely on alone
In the best studies, the leading app missed about 1 in 5 malignant lesions — with photos taken by doctors. Why apps cannot rule out melanoma.
CardiovascularStatins for prevention: who really benefits
Statins cut cardiovascular events by about a fifth per mmol/L of LDL lowered. Whether that matters for you depends on your baseline risk — and most muscle aches are nocebo.
A surgeon's viewWhat I see differently about prevention as a surgeon
Surgeons see where screening leads: operations on harmless findings, but also cancers found too late. Why the value of not operating matters as much as early detection.
EvidenceWhy Cochrane says standard check-ups don't work
251,891 patients. 17 trials. Zero mortality benefit. What the largest health-screening review actually found — and what to ask for instead.
CardiovascularThe two lipid markers your cholesterol panel is missing
ApoB counts every atherogenic particle. Lp(a) reveals a genetic risk that affects 1 in 5 people. Neither is part of most standard check-ups.
LongevityThe biological age test that actually works
Most bio-age tests are noise. DunedinPACE is different — it responded to an intervention in a randomized trial. Here's what it measures and what it doesn't.
MetabolicInsulin resistance: the silent decade before diabetes
Type 2 diabetes is often preceded by a decade or more of rising insulin resistance — invisible on a standard check-up.
OncologyLow-dose chest CT: the lung cancer screening that saves lives
20% mortality reduction in high-risk smokers. Two landmark trials, nearly 70,000 participants. Why most eligible people have never been offered this test.
ImagingWhole-body MRI: powerful tool or overdiagnosis machine?
Relevant incidental findings in about 1 in 3 people. No mortality RCT. When a whole-body scan can make sense, when it doesn't, and why the distinction matters.
FitnessVO₂max: one of the strongest predictors of how long you'll live
Low fitness carries a mortality risk comparable to or greater than smoking, diabetes, or coronary artery disease. And unlike those, you can improve it at any age.
NutritionVitamin D: the deficiency that affects 40% of Europeans
Essential for bone health, modest evidence for infections, overhyped for everything else. What the science actually says — and what it doesn't.
OncologyColonoscopy: one of the best-supported cancer screenings
About half fewer colorectal cancer deaths among those actually screened in the largest randomised trial. The one screening test that can find and remove precancerous lesions in the same session.
CardiovascularCoronary calcium score: the 10-minute cardiac risk scan
A CAC of zero means a low ten-year risk (about 3% in the MESA study). A CAC above 400 signals high risk. The scan reclassifies about half of intermediate-risk patients.
MetabolicFatty liver disease: the silent epidemic
Over 30% prevalence. Many cases have normal ALT. Why standard liver tests miss fatty liver disease — and what to look for instead.
FitnessGrip strength: the 5-second test that predicts mortality
Nearly 140,000 people across 17 countries. Each 5 kg lower grip strength was linked to 16% higher all-cause mortality — a stronger predictor than systolic blood pressure.
CardiovascularSleep: the risk factor your doctor rarely asks about
Short sleep was linked to a 48% higher coronary risk. Moderate-to-severe sleep apnea affects about 1 in 6 men aged 50–70. Many cases go undiagnosed.
MetabolicHbA1c vs. fasting glucose: why you need both
One is a snapshot, one is a 3-month average. Both have blind spots. Fasting insulin can add an earlier, if less standardized, signal.
HormonesTestosterone replacement: when it helps, when it harms
The TRAVERSE trial (n=5,246) found more atrial fibrillation, kidney injury and pulmonary embolism. Why testosterone 'optimization' at normal levels is a bad bet.
MetabolicOzempic and the GLP-1 revolution: what the evidence shows
14.9% weight loss. 20% CV event reduction. But also: nausea, rebound, and muscle loss. The complete evidence picture.
NutritionSupplements: the few that work and the many that don't
Vitamin D, B12, magnesium — yes, if deficient. NAD+, collagen, multivitamins — little to show. Why measuring comes before supplementing.
LongevityLongevity medicine: separating science from marketing
NAD+ infusions, peptide therapy, exosomes — the gap between what is being researched and what is being sold is enormous.
MetabolicMetabolic syndrome: five markers, one diagnosis
About 35% of US adults meet the criteria. Many don't know it. Several borderline numbers together can signal more risk than any one of them suggests.
OncologyPSA screening: the most controversial test in medicine
20% fewer prostate cancer deaths — but about 18 extra diagnoses for every death prevented. Why shared decision-making is the only right approach.
DermatologySkin cancer screening: why dermatoscopy beats the naked eye
Naked-eye sensitivity: about 76%. With dermatoscopy: about 92%. For melanoma, where stage at detection determines survival, that gap is life or death.
FitnessWhen exercise beats the prescription pad
58% diabetes reduction (vs. 31% with metformin). Depression benefits comparable to SSRIs. Blood pressure reduction matching first-line drugs.
EvidenceWhat your annual physical actually misses
ApoB, Lp(a), HOMA-IR, VO₂max, body composition, micronutrients — six critical blind spots in the standard check-up.
EvidenceHow to read your lab results: what "normal" means
"Normal" on a lab report means "middle 95% of the reference population" — not "healthy." How to interpret your numbers properly.
CardiovascularJet lag and your heart: what frequent flying does
Six time zones = up to six days of circadian misalignment. Irregular sleep is linked to 26% more cardiovascular events. What frequent flyers need to know.
EvidenceAlcohol: what "moderate drinking" actually means in 2026
The "one glass is good for you" story does not hold up. A 2023 meta-analysis of nearly 5 million participants found no survival benefit from low-volume drinking.
CardiovascularStress, cortisol, and the high achiever's paradox
They exercise, eat well, have good insurance — and some still have elevated inflammatory markers. Chronic stress is often the missing variable.
EvidenceWomen's health: the gap in standard check-ups
Women are often underserved by standard preventive care. Perimenopause, breast screening, osteoporosis, heart disease and thyroid: what a check-up should cover.
FitnessSitting is not the new smoking — but it's close
18% higher CV death risk from prolonged sitting, independent of exercise. The 30-minute run doesn't neutralize 10 hours in a chair.
EvidenceRed flags your doctor should catch — but often doesn't
Unintentional weight change, night sweats, bowel habit changes, persistent fatigue — symptoms that fall through the cracks in 15-minute visits.
EvidenceFamily history: the most powerful tool that costs nothing
A 20-minute phone call with your parents may be one of the most valuable things you do for your health. Three generations of history often change which tests make sense.
EvidenceThe annual physical is dead — long live the health assessment
251,891 participants. No mortality benefit. Why the 15-minute annual visit should give way to risk-stratified assessments at sensible intervals.
EvidenceWhen a screening test finds something: what should happen next
Most screening findings are manageable, but a few are serious. What types of findings exist, what a good follow-up process looks like, and which questions to ask.
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