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Conceivably, a better biomarker for smoking could increase the effectiveness of preventive interventions.
Yet, there is insufficient evidence regarding the effectiveness of preventive interventions in this setting.
The study is a multifactorial and multidisciplinary study assessing effectiveness of preventive interventions in older people in the general practice.
With linked population data sets programme/policy evaluation and economic models can also be investigated (such as the effectiveness of preventive interventions which are traditionally hard to quantify).
There is therefore potential for stratifying risk and acting as a biomarker of effectiveness of preventive interventions (Li et al, 2013).
Because of the long latency between initiation and diagnosis of most cancers, the effectiveness of preventive interventions, such as the success of smoking cessation programs, will not become apparent until years or even decades after implementation.
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Lack of data on the sustainability (or maintenance) of behavioural changes is the key unknown in modelling cost-effectiveness of preventive interventions.
Since the Dutch informal threshold for cost-effectiveness of preventive interventions is EUR 20,000 per QALY, the pedometer scenario appeared to be cost-effective.
Still, a few studies on the cost-effectiveness of preventive interventions aimed at reducing arm, shoulder or neck symptoms, in different working populations, have been published in the last decade.
Finally, a more careful assessment of the cost-effectiveness of preventive interventions used and a more systematic evaluation of issues related to the emergence of drug resistance are necessary.
Specifically, the article by Bray and colleagues (7) comments on the long-term observations of metformin use as a preventive strategy, whereas the article by Herman and colleagues (8) provides interesting data on the cost-effectiveness of preventive interventions as observed over a long-term period.
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