What to screen, and when.

Use ApoB alongside or instead of LDL-C for risk stratification, particularly with metabolic syndrome or hypertriglyceridaemia.

AACE/ACE 2017 · +1 more

Optional addition to global risk assessment in intermediate-risk adults; repeat fasting if elevated to rule out transient cause.

AHA/CDC 2003 · +1 more

Risk-stratified screening from age 40 (or 25 in some South Asian populations).

NICE NG28

Routine screening of healthy adults not recommended; test those with risk factors (limited sun exposure, malabsorption, dark skin in high-latitude climates, osteoporosis).

Endocrine Society 2024 · +1 more

Test in adults with unexplained fatigue, reduced exercise capacity, restless legs, hair loss, or menstrual blood loss.

BSH 2021 · +1 more

Measure at least once in every adult's lifetime; reasonable in young adulthood. Repeat testing usually not needed.

ESC 2019 dyslipidaemia · +1 more

Reasonable to measure once as part of an extended cardiovascular workup; repeat if intervening on B12/folate.

B-vitamin guideline consensus

Consider when family history of T2D, PCOS, NAFLD, or abdominal obesity — particularly if HbA1c is still normal.

Endocrine consensus

Useful when investigating early insulin resistance; less helpful once diabetes is established.

Common practice

Useful once to establish baseline; repeat 3–6 months after starting or stopping omega-3 supplementation.

Common practice

Insufficient evidence for routine CKD screening in asymptomatic adults without risk factors.

USPSTF 2024

Use cystatin C when creatinine-based eGFR is suspected to misclassify (extreme body composition, or borderline result).

KDIGO 2024

Insufficient evidence for routine screening in asymptomatic, non-pregnant adults.

USPSTF 2015

Test alongside TSH when TSH is abnormal, or when central thyroid disease is suspected.

ATA 2014

Measure in men with consistent symptoms (low libido, fatigue, depressed mood, reduced muscle mass). Repeat for confirmation before treating.

Endocrine Society 2018 (men) · +1 more

Evaluate persistently elevated ALT regardless of magnitude; investigate metabolic, alcohol, viral, and drug causes.

AASLD 2017 (Kwo) · +1 more

Helpful when characterising hepatobiliary patterns alongside ALT, AST, ALP. Routine isolated screening not recommended.

AASLD 2017 (Kwo)

Reviewed at any routine blood draw. Trend over years carries more signal than any single value.

Standard panel inclusion

Shared decision-making from age 50; from 45 with elevated risk (family history, African American men).

ACS 2024

Test in adults with unexplained anaemia, macrocytosis, neurological symptoms, glossitis, or risk factors (vegan/vegetarian diet, metformin or PPI use, autoimmune conditions, prior gastrointestinal surgery).

BCSH 2014 (Devalia) · +1 more

Measure alongside B12 when investigating macrocytic anaemia, unexplained symptoms, or pre-pregnancy planning.

BCSH 2014

Order alongside ferritin when symptoms suggest iron deficiency despite normal ferritin, or when ferritin is elevated and overload is being considered.

BSH 2021

Reviewed at any routine blood draw. Trend matters more than single-point values.

Standard panel inclusion

Annual measurement in all adults with type 2 diabetes from diagnosis; annual in type 1 from 5 years post-diagnosis.

ADA 2024

Indicated when GH excess (acromegaly) or deficiency is suspected. Routine population screening of healthy adults not recommended.

Endocrine Society 2014 / 2019

Risk-stratified screening from age 50, earlier if specific risk factors (steroid use, premature menopause, prior fragility fracture).

NOGG 2021 (UK)

Repeat scoring after 5–7 years is informative for risk re-classification.

MESA cohort guidance

10-year interval after a high-quality normal colonoscopy in average-risk adults.

ESGE 2020

Same eligibility plus consideration for additional risk factors (occupational exposure, family history).

NCCN 2024

One-time ultrasound for men in the year they turn 65.

NHS AAA Screening Programme · +1 more

Insufficient evidence for routine population screening of asymptomatic adults.

USPSTF 2023 · +1 more

Appropriate confirmatory study for uncomplicated suspected moderate-severe OSA. Not suitable for cases with significant comorbidity, suspected central apnea, or pediatric.

AASM 2017

Indicated when HSAT is inconclusive, when comorbidities or atypical presentations exist, for suspected central apnea, periodic limb movement disorder, parasomnias, or pediatric assessment.

AASM 2017

May be considered when other risk modifiers are needed; not routine first-line.

ESC 2021 · +1 more

Standardised protocol for clinical and research use. Periodic monitoring useful when tracking rehabilitation progress.

ATS / ERS 2014

Daily morning measurement is the validated cadence; trends over 7-day rolling averages are what's actionable, not absolute single values.

HRV4Training validation · +1 more

Cardiorespiratory fitness should be considered a clinical vital sign; reasonable to assess (by estimation or formal test) at routine preventive visits.

AHA 2016 · +1 more

Track as a daily/weekly metric; trends matter more than single readings.

AHA 2016

Track over weekly rolling averages; identify patterns rather than fixating on single nights.

AASM 2015

Annual screening for adults 40+; every 3–5 years for adults 18–39 at low risk. Home or ambulatory confirmation before diagnosing hypertension.

USPSTF 2021 · +3 more

Useful at any age; track monthly when working on body composition, otherwise annually.

WHO 2008 · +1 more

Screen adults with risk factors for OSA — habitual snoring, witnessed apneas, daytime sleepiness, BMI > 35, treatment-resistant hypertension, atrial fibrillation.

AASM 2017 · +2 more

Used as part of OSA screening alongside STOP-Bang.

AASM 2017

Recommends screening for depression in all adults; instruments like PHQ-9 are the standard tool.

USPSTF 2023

Recommends screening for anxiety disorders in all adults aged 19–64.

USPSTF 2023

Used when cognitive concern is raised by patient, family, or clinician. Routine population screening of asymptomatic adults is not recommended.

ADA 2024 / Choosing Wisely

Used in clinical sleep evaluation and CBT-i outcomes tracking.

AASM 2014

Recommends screening for unhealthy alcohol use in adults aged 18+ with brief intervention for those at risk. AUDIT-C is the most-used screening instrument.

USPSTF 2018

Useful as a baseline and periodic re-measure during major life transitions (retirement, bereavement, relocation).

Common research / clinical practice

Initiate workup if STOP-Bang ≥3 or ESS ≥11 with consistent symptoms; HSAT acceptable for uncomplicated suspected moderate-severe OSA; PSG for ambiguous or comorbid cases.

AASM 2017

Use ApoB alongside or instead of LDL-C for risk stratification, particularly with metabolic syndrome or hypertriglyceridaemia.

AACE/ACE 2017 · +1 more

Optional addition to global risk assessment in intermediate-risk adults; repeat fasting if elevated to rule out transient cause.

AHA/CDC 2003 · +1 more

Risk-stratified screening from age 40 (or 25 in some South Asian populations).

NICE NG28

Routine screening of healthy adults not recommended; test those with risk factors (limited sun exposure, malabsorption, dark skin in high-latitude climates, osteoporosis).

Endocrine Society 2024 · +1 more

Test in adults with unexplained fatigue, reduced exercise capacity, restless legs, hair loss, or menstrual blood loss.

BSH 2021 · +1 more

Measure at least once in every adult's lifetime; reasonable in young adulthood. Repeat testing usually not needed.

ESC 2019 dyslipidaemia · +1 more

Reasonable to measure once as part of an extended cardiovascular workup; repeat if intervening on B12/folate.

B-vitamin guideline consensus

Consider when family history of T2D, PCOS, NAFLD, or abdominal obesity — particularly if HbA1c is still normal.

Endocrine consensus

Useful when investigating early insulin resistance; less helpful once diabetes is established.

Common practice

Useful once to establish baseline; repeat 3–6 months after starting or stopping omega-3 supplementation.

Common practice

Insufficient evidence for routine CKD screening in asymptomatic adults without risk factors.

USPSTF 2024

Use cystatin C when creatinine-based eGFR is suspected to misclassify (extreme body composition, or borderline result).

KDIGO 2024

Insufficient evidence for routine screening in asymptomatic, non-pregnant adults.

USPSTF 2015

Test alongside TSH when TSH is abnormal, or when central thyroid disease is suspected.

ATA 2014

Measure in men with consistent symptoms (low libido, fatigue, depressed mood, reduced muscle mass). Repeat for confirmation before treating.

Endocrine Society 2018 (men) · +1 more

Evaluate persistently elevated ALT regardless of magnitude; investigate metabolic, alcohol, viral, and drug causes.

AASLD 2017 (Kwo) · +1 more

Helpful when characterising hepatobiliary patterns alongside ALT, AST, ALP. Routine isolated screening not recommended.

AASLD 2017 (Kwo)

Reviewed at any routine blood draw. Trend over years carries more signal than any single value.

Standard panel inclusion

Shared decision-making from age 50; from 45 with elevated risk (family history, African American men).

ACS 2024

Test in adults with unexplained anaemia, macrocytosis, neurological symptoms, glossitis, or risk factors (vegan/vegetarian diet, metformin or PPI use, autoimmune conditions, prior gastrointestinal surgery).

BCSH 2014 (Devalia) · +1 more

Measure alongside B12 when investigating macrocytic anaemia, unexplained symptoms, or pre-pregnancy planning.

BCSH 2014

Order alongside ferritin when symptoms suggest iron deficiency despite normal ferritin, or when ferritin is elevated and overload is being considered.

BSH 2021

Reviewed at any routine blood draw. Trend matters more than single-point values.

Standard panel inclusion

Annual measurement in all adults with type 2 diabetes from diagnosis; annual in type 1 from 5 years post-diagnosis.

ADA 2024

Indicated when GH excess (acromegaly) or deficiency is suspected. Routine population screening of healthy adults not recommended.

Endocrine Society 2014 / 2019

Risk-stratified screening from age 50, earlier if specific risk factors (steroid use, premature menopause, prior fragility fracture).

NOGG 2021 (UK)

Repeat scoring after 5–7 years is informative for risk re-classification.

MESA cohort guidance

10-year interval after a high-quality normal colonoscopy in average-risk adults.

ESGE 2020

Same eligibility plus consideration for additional risk factors (occupational exposure, family history).

NCCN 2024

One-time ultrasound for men in the year they turn 65.

NHS AAA Screening Programme · +1 more

Insufficient evidence for routine population screening of asymptomatic adults.

USPSTF 2023 · +1 more

Appropriate confirmatory study for uncomplicated suspected moderate-severe OSA. Not suitable for cases with significant comorbidity, suspected central apnea, or pediatric.

AASM 2017

Indicated when HSAT is inconclusive, when comorbidities or atypical presentations exist, for suspected central apnea, periodic limb movement disorder, parasomnias, or pediatric assessment.

AASM 2017

May be considered when other risk modifiers are needed; not routine first-line.

ESC 2021 · +1 more

Standardised protocol for clinical and research use. Periodic monitoring useful when tracking rehabilitation progress.

ATS / ERS 2014

Reasonable annual self-tracking from age 30. Cohort evidence is strongest in middle-aged adults.

ACSM 2022

Daily morning measurement is the validated cadence; trends over 7-day rolling averages are what's actionable, not absolute single values.

HRV4Training validation · +1 more

Cardiorespiratory fitness should be considered a clinical vital sign; reasonable to assess (by estimation or formal test) at routine preventive visits.

AHA 2016 · +1 more

Track as a daily/weekly metric; trends matter more than single readings.

AHA 2016

Track over weekly rolling averages; identify patterns rather than fixating on single nights.

AASM 2015

Annual screening for adults 40+; every 3–5 years for adults 18–39 at low risk. Home or ambulatory confirmation before diagnosing hypertension.

USPSTF 2021 · +3 more

Useful at any age; track monthly when working on body composition, otherwise annually.

WHO 2008 · +1 more

Screen adults with risk factors for OSA — habitual snoring, witnessed apneas, daytime sleepiness, BMI > 35, treatment-resistant hypertension, atrial fibrillation.

AASM 2017 · +2 more

Used as part of OSA screening alongside STOP-Bang.

AASM 2017

Recommends screening for depression in all adults; instruments like PHQ-9 are the standard tool.

USPSTF 2023

Recommends screening for anxiety disorders in all adults aged 19–64.

USPSTF 2023

Used when cognitive concern is raised by patient, family, or clinician. Routine population screening of asymptomatic adults is not recommended.

ADA 2024 / Choosing Wisely

Used in clinical sleep evaluation and CBT-i outcomes tracking.

AASM 2014

Recommends screening for unhealthy alcohol use in adults aged 18+ with brief intervention for those at risk. AUDIT-C is the most-used screening instrument.

USPSTF 2018

Useful as a baseline and periodic re-measure during major life transitions (retirement, bereavement, relocation).

Common research / clinical practice

Initiate workup if STOP-Bang ≥3 or ESS ≥11 with consistent symptoms; HSAT acceptable for uncomplicated suspected moderate-severe OSA; PSG for ambiguous or comorbid cases.

AASM 2017

Measure at least once in all adults; repeat every 5 years if low-risk, more frequently if elevated.

ESC 2021 Prevention · +2 more

Optional addition to global risk assessment in intermediate-risk adults; repeat fasting if elevated to rule out transient cause.

AHA/CDC 2003 · +1 more

Screen for prediabetes/diabetes in adults 35–70 who are overweight or obese; every 3 years if normal.

USPSTF 2021 · +2 more

Routine screening of healthy adults not recommended; test those with risk factors (limited sun exposure, malabsorption, dark skin in high-latitude climates, osteoporosis).

Endocrine Society 2024 · +1 more

Test in adults with unexplained fatigue, reduced exercise capacity, restless legs, hair loss, or menstrual blood loss.

BSH 2021 · +1 more

Measure at least once in every adult's lifetime; reasonable in young adulthood. Repeat testing usually not needed.

ESC 2019 dyslipidaemia · +1 more

Reasonable to measure once as part of an extended cardiovascular workup; repeat if intervening on B12/folate.

B-vitamin guideline consensus

Consider when family history of T2D, PCOS, NAFLD, or abdominal obesity — particularly if HbA1c is still normal.

Endocrine consensus

Useful when investigating early insulin resistance; less helpful once diabetes is established.

Common practice

Part of standard lipid screening from age 40 (or earlier with risk factors).

ESC 2019 dyslipidaemia

Useful once to establish baseline; repeat 3–6 months after starting or stopping omega-3 supplementation.

Common practice

Annual creatinine + eGFR for adults with diabetes, hypertension, or known CKD. Reasonable every 2–3 years for healthy adults from age 40.

KDIGO 2024 · +1 more

Use cystatin C when creatinine-based eGFR is suspected to misclassify (extreme body composition, or borderline result).

KDIGO 2024

Routine screening from age 35, repeat every 5 years. Earlier or more frequent with risk factors (autoimmune disease, neck irradiation, pregnancy planning).

ATA 2014 · +1 more

Test alongside TSH when TSH is abnormal, or when central thyroid disease is suspected.

ATA 2014

Measure in men with consistent symptoms (low libido, fatigue, depressed mood, reduced muscle mass). Repeat for confirmation before treating.

Endocrine Society 2018 (men) · +1 more

Part of routine cardiovascular risk assessment from age 40.

ESC 2021

Part of routine cardiovascular risk assessment from age 40.

ESC 2021

Reported alongside LDL-C in modern panels.

ESC 2021

Screen for prediabetes and type 2 diabetes in adults 35–70 with overweight or obesity; every 3 years if normal.

USPSTF 2021 · +1 more

Evaluate persistently elevated ALT regardless of magnitude; investigate metabolic, alcohol, viral, and drug causes.

AASLD 2017 (Kwo) · +1 more

Helpful when characterising hepatobiliary patterns alongside ALT, AST, ALP. Routine isolated screening not recommended.

AASLD 2017 (Kwo)

Reviewed at any routine blood draw. Trend over years carries more signal than any single value.

Standard panel inclusion

Shared decision-making from age 50; from 45 with elevated risk (family history, African American men).

ACS 2024

Test in adults with unexplained anaemia, macrocytosis, neurological symptoms, glossitis, or risk factors (vegan/vegetarian diet, metformin or PPI use, autoimmune conditions, prior gastrointestinal surgery).

BCSH 2014 (Devalia) · +1 more

Measure alongside B12 when investigating macrocytic anaemia, unexplained symptoms, or pre-pregnancy planning.

BCSH 2014

Order alongside ferritin when symptoms suggest iron deficiency despite normal ferritin, or when ferritin is elevated and overload is being considered.

BSH 2021

Reviewed at any routine blood draw. Trend matters more than single-point values.

Standard panel inclusion

Annual for adults with diabetes, hypertension, cardiovascular disease, or family history of CKD. Reasonable every 2–3 years for healthy adults from age 40.

KDIGO 2024 · +1 more

Indicated when GH excess (acromegaly) or deficiency is suspected. Routine population screening of healthy adults not recommended.

Endocrine Society 2014 / 2019

Risk-stratified screening from age 50, earlier if specific risk factors (steroid use, premature menopause, prior fragility fracture).

NOGG 2021 (UK)

Class IIa for adults aged 40–75 at borderline-to-intermediate 10-year ASCVD risk (5–20%); particularly useful when decision-making about statin therapy is uncertain.

ACC/AHA 2018 · +2 more

Biennial screening for women 40–74 at average risk.

USPSTF 2024

10-year interval after a high-quality normal colonoscopy in average-risk adults.

ESGE 2020

Same eligibility plus consideration for additional risk factors (occupational exposure, family history).

NCCN 2024

One-time ultrasound for men in the year they turn 65.

NHS AAA Screening Programme · +1 more

Insufficient evidence for routine population screening of asymptomatic adults.

USPSTF 2023 · +2 more

Appropriate confirmatory study for uncomplicated suspected moderate-severe OSA. Not suitable for cases with significant comorbidity, suspected central apnea, or pediatric.

AASM 2017

Indicated when HSAT is inconclusive, when comorbidities or atypical presentations exist, for suspected central apnea, periodic limb movement disorder, parasomnias, or pediatric assessment.

AASM 2017

May be considered when other risk modifiers are needed; not routine first-line.

ESC 2021 · +1 more

Useful as an annual self-tracked metric from age 40 onwards.

Bohannon norms

Standardised protocol for clinical and research use. Periodic monitoring useful when tracking rehabilitation progress.

ATS / ERS 2014

Reasonable annual self-tracking from age 30. Cohort evidence is strongest in middle-aged adults.

ACSM 2022

Daily morning measurement is the validated cadence; trends over 7-day rolling averages are what's actionable, not absolute single values.

HRV4Training validation · +1 more

Cardiorespiratory fitness should be considered a clinical vital sign; reasonable to assess (by estimation or formal test) at routine preventive visits.

AHA 2016 · +1 more

Track as a daily/weekly metric; trends matter more than single readings.

AHA 2016

Track over weekly rolling averages; identify patterns rather than fixating on single nights.

AASM 2015

Annual screening for adults 40+; every 3–5 years for adults 18–39 at low risk. Home or ambulatory confirmation before diagnosing hypertension.

USPSTF 2021 · +3 more

Useful at any age; track monthly when working on body composition, otherwise annually.

WHO 2008 · +1 more

Screen adults with risk factors for OSA — habitual snoring, witnessed apneas, daytime sleepiness, BMI > 35, treatment-resistant hypertension, atrial fibrillation.

AASM 2017 · +2 more

Used as part of OSA screening alongside STOP-Bang.

AASM 2017

Recommends screening for depression in all adults; instruments like PHQ-9 are the standard tool.

USPSTF 2023

Recommends screening for anxiety disorders in all adults aged 19–64.

USPSTF 2023

Used when cognitive concern is raised by patient, family, or clinician. Routine population screening of asymptomatic adults is not recommended.

ADA 2024 / Choosing Wisely

Used in clinical sleep evaluation and CBT-i outcomes tracking.

AASM 2014

Recommends screening for unhealthy alcohol use in adults aged 18+ with brief intervention for those at risk. AUDIT-C is the most-used screening instrument.

USPSTF 2018

Useful as a baseline and periodic re-measure during major life transitions (retirement, bereavement, relocation).

Common research / clinical practice

Initiate workup if STOP-Bang ≥3 or ESS ≥11 with consistent symptoms; HSAT acceptable for uncomplicated suspected moderate-severe OSA; PSG for ambiguous or comorbid cases.

AASM 2017

Measure at least once in all adults; repeat every 5 years if low-risk, more frequently if elevated.

ESC 2021 Prevention · +2 more

Optional addition to global risk assessment in intermediate-risk adults; repeat fasting if elevated to rule out transient cause.

AHA/CDC 2003 · +1 more

Screen for prediabetes/diabetes in adults 35–70 who are overweight or obese; every 3 years if normal.

USPSTF 2021 · +2 more

Routine screening of healthy adults not recommended; test those with risk factors (limited sun exposure, malabsorption, dark skin in high-latitude climates, osteoporosis).

Endocrine Society 2024 · +1 more

Test in adults with unexplained fatigue, reduced exercise capacity, restless legs, hair loss, or menstrual blood loss.

BSH 2021 · +1 more

Measure at least once in every adult's lifetime; reasonable in young adulthood. Repeat testing usually not needed.

ESC 2019 dyslipidaemia · +1 more

Reasonable to measure once as part of an extended cardiovascular workup; repeat if intervening on B12/folate.

B-vitamin guideline consensus

Consider when family history of T2D, PCOS, NAFLD, or abdominal obesity — particularly if HbA1c is still normal.

Endocrine consensus

Useful when investigating early insulin resistance; less helpful once diabetes is established.

Common practice

Part of standard lipid screening from age 40 (or earlier with risk factors).

ESC 2019 dyslipidaemia

Useful once to establish baseline; repeat 3–6 months after starting or stopping omega-3 supplementation.

Common practice

Annual creatinine + eGFR for adults with diabetes, hypertension, or known CKD. Reasonable every 2–3 years for healthy adults from age 40.

KDIGO 2024 · +1 more

Use cystatin C when creatinine-based eGFR is suspected to misclassify (extreme body composition, or borderline result).

KDIGO 2024

Routine screening from age 35, repeat every 5 years. Earlier or more frequent with risk factors (autoimmune disease, neck irradiation, pregnancy planning).

ATA 2014 · +1 more

Test alongside TSH when TSH is abnormal, or when central thyroid disease is suspected.

ATA 2014

Measure in men with consistent symptoms (low libido, fatigue, depressed mood, reduced muscle mass). Repeat for confirmation before treating.

Endocrine Society 2018 (men) · +1 more

Part of routine cardiovascular risk assessment from age 40.

ESC 2021

Part of routine cardiovascular risk assessment from age 40.

ESC 2021

Reported alongside LDL-C in modern panels.

ESC 2021

Screen for prediabetes and type 2 diabetes in adults 35–70 with overweight or obesity; every 3 years if normal.

USPSTF 2021 · +1 more

Evaluate persistently elevated ALT regardless of magnitude; investigate metabolic, alcohol, viral, and drug causes.

AASLD 2017 (Kwo) · +1 more

Helpful when characterising hepatobiliary patterns alongside ALT, AST, ALP. Routine isolated screening not recommended.

AASLD 2017 (Kwo)

Reviewed at any routine blood draw. Trend over years carries more signal than any single value.

Standard panel inclusion

Risk-adapted screening from age 50 (or 45 with family history / African ancestry). Multiparametric MRI before biopsy if PSA elevated.

EAU 2024 · +1 more

Test in adults with unexplained anaemia, macrocytosis, neurological symptoms, glossitis, or risk factors (vegan/vegetarian diet, metformin or PPI use, autoimmune conditions, prior gastrointestinal surgery).

BCSH 2014 (Devalia) · +1 more

Measure alongside B12 when investigating macrocytic anaemia, unexplained symptoms, or pre-pregnancy planning.

BCSH 2014

Order alongside ferritin when symptoms suggest iron deficiency despite normal ferritin, or when ferritin is elevated and overload is being considered.

BSH 2021

Reviewed at any routine blood draw. Trend matters more than single-point values.

Standard panel inclusion

Annual for adults with diabetes, hypertension, cardiovascular disease, or family history of CKD. Reasonable every 2–3 years for healthy adults from age 40.

KDIGO 2024 · +1 more

Indicated when GH excess (acromegaly) or deficiency is suspected. Routine population screening of healthy adults not recommended.

Endocrine Society 2014 / 2019

Risk-stratified screening from age 50, earlier if specific risk factors (steroid use, premature menopause, prior fragility fracture).

NOGG 2021 (UK)

Class IIa for adults aged 40–75 at borderline-to-intermediate 10-year ASCVD risk (5–20%); particularly useful when decision-making about statin therapy is uncertain.

ACC/AHA 2018 · +2 more

Biennial screening for women 40–74 at average risk.

USPSTF 2024 · +2 more

Screening for adults 45–75; choice of FIT (annually), sigmoidoscopy + FIT, or colonoscopy (every 10 years if normal).

USPSTF 2021 · +2 more

Annual LDCT for adults 50–80 with ≥20 pack-year smoking history who currently smoke or quit within the past 15 years.

USPSTF 2021 · +1 more

One-time ultrasound for men in the year they turn 65.

NHS AAA Screening Programme · +1 more

Insufficient evidence for routine population screening of asymptomatic adults.

USPSTF 2023 · +2 more

Appropriate confirmatory study for uncomplicated suspected moderate-severe OSA. Not suitable for cases with significant comorbidity, suspected central apnea, or pediatric.

AASM 2017

Indicated when HSAT is inconclusive, when comorbidities or atypical presentations exist, for suspected central apnea, periodic limb movement disorder, parasomnias, or pediatric assessment.

AASM 2017

Class IIa for cardiovascular risk assessment in asymptomatic adults at intermediate risk where additional risk stratification would change management. Less emphasised in subsequent guidelines as coronary calcium has gained ground.

ACC/AHA 2010 · +2 more

Useful as an annual self-tracked metric from age 40 onwards.

Bohannon norms

Standardised protocol for clinical and research use. Periodic monitoring useful when tracking rehabilitation progress.

ATS / ERS 2014

Reasonable annual self-tracking from age 30. Cohort evidence is strongest in middle-aged adults.

ACSM 2022

Daily morning measurement is the validated cadence; trends over 7-day rolling averages are what's actionable, not absolute single values.

HRV4Training validation · +1 more

Cardiorespiratory fitness should be considered a clinical vital sign; reasonable to assess (by estimation or formal test) at routine preventive visits.

AHA 2016 · +1 more

Track as a daily/weekly metric; trends matter more than single readings.

AHA 2016

Track over weekly rolling averages; identify patterns rather than fixating on single nights.

AASM 2015

Annual screening for adults 40+; every 3–5 years for adults 18–39 at low risk. Home or ambulatory confirmation before diagnosing hypertension.

USPSTF 2021 · +3 more

Useful at any age; track monthly when working on body composition, otherwise annually.

WHO 2008 · +1 more

Screen adults with risk factors for OSA — habitual snoring, witnessed apneas, daytime sleepiness, BMI > 35, treatment-resistant hypertension, atrial fibrillation.

AASM 2017 · +2 more

Used as part of OSA screening alongside STOP-Bang.

AASM 2017

Recommends screening for depression in all adults; instruments like PHQ-9 are the standard tool.

USPSTF 2023

Recommends screening for anxiety disorders in all adults aged 19–64.

USPSTF 2023

Used when cognitive concern is raised by patient, family, or clinician. Routine population screening of asymptomatic adults is not recommended.

ADA 2024 / Choosing Wisely

Used in clinical sleep evaluation and CBT-i outcomes tracking.

AASM 2014

Recommends screening for unhealthy alcohol use in adults aged 18+ with brief intervention for those at risk. AUDIT-C is the most-used screening instrument.

USPSTF 2018

Useful as a baseline and periodic re-measure during major life transitions (retirement, bereavement, relocation).

Common research / clinical practice

Initiate workup if STOP-Bang ≥3 or ESS ≥11 with consistent symptoms; HSAT acceptable for uncomplicated suspected moderate-severe OSA; PSG for ambiguous or comorbid cases.

AASM 2017

Measure at least once in all adults; repeat every 5 years if low-risk, more frequently if elevated.

ESC 2021 Prevention · +2 more

Optional addition to global risk assessment in intermediate-risk adults; repeat fasting if elevated to rule out transient cause.

AHA/CDC 2003 · +1 more

Screen for prediabetes/diabetes in adults 35–70 who are overweight or obese; every 3 years if normal.

USPSTF 2021 · +2 more

Routine screening of healthy adults not recommended; test those with risk factors (limited sun exposure, malabsorption, dark skin in high-latitude climates, osteoporosis).

Endocrine Society 2024 · +1 more

Test in adults with unexplained fatigue, reduced exercise capacity, restless legs, hair loss, or menstrual blood loss.

BSH 2021 · +1 more

Measure at least once in every adult's lifetime; reasonable in young adulthood. Repeat testing usually not needed.

ESC 2019 dyslipidaemia · +1 more

Reasonable to measure once as part of an extended cardiovascular workup; repeat if intervening on B12/folate.

B-vitamin guideline consensus

Consider when family history of T2D, PCOS, NAFLD, or abdominal obesity — particularly if HbA1c is still normal.

Endocrine consensus

Useful when investigating early insulin resistance; less helpful once diabetes is established.

Common practice

Part of standard lipid screening from age 40 (or earlier with risk factors).

ESC 2019 dyslipidaemia

Useful once to establish baseline; repeat 3–6 months after starting or stopping omega-3 supplementation.

Common practice

Annual creatinine + eGFR for adults with diabetes, hypertension, or known CKD. Reasonable every 2–3 years for healthy adults from age 40.

KDIGO 2024 · +1 more

Use cystatin C when creatinine-based eGFR is suspected to misclassify (extreme body composition, or borderline result).

KDIGO 2024

Routine screening from age 35, repeat every 5 years. Earlier or more frequent with risk factors (autoimmune disease, neck irradiation, pregnancy planning).

ATA 2014 · +1 more

Test alongside TSH when TSH is abnormal, or when central thyroid disease is suspected.

ATA 2014

Measure in men with consistent symptoms (low libido, fatigue, depressed mood, reduced muscle mass). Repeat for confirmation before treating.

Endocrine Society 2018 (men) · +1 more

Part of routine cardiovascular risk assessment from age 40.

ESC 2021

Part of routine cardiovascular risk assessment from age 40.

ESC 2021

Reported alongside LDL-C in modern panels.

ESC 2021

Screen for prediabetes and type 2 diabetes in adults 35–70 with overweight or obesity; every 3 years if normal.

USPSTF 2021 · +1 more

Evaluate persistently elevated ALT regardless of magnitude; investigate metabolic, alcohol, viral, and drug causes.

AASLD 2017 (Kwo) · +1 more

Helpful when characterising hepatobiliary patterns alongside ALT, AST, ALP. Routine isolated screening not recommended.

AASLD 2017 (Kwo)

Reviewed at any routine blood draw. Trend over years carries more signal than any single value.

Standard panel inclusion

Grade C (individual shared decision-making) for men 55–74. Grade D (recommend against) for men 70+. Strong emphasis on understanding overdiagnosis trade-off.

USPSTF 2018 · +2 more

Test in adults with unexplained anaemia, macrocytosis, neurological symptoms, glossitis, or risk factors (vegan/vegetarian diet, metformin or PPI use, autoimmune conditions, prior gastrointestinal surgery).

BCSH 2014 (Devalia) · +1 more

Measure alongside B12 when investigating macrocytic anaemia, unexplained symptoms, or pre-pregnancy planning.

BCSH 2014

Order alongside ferritin when symptoms suggest iron deficiency despite normal ferritin, or when ferritin is elevated and overload is being considered.

BSH 2021

Reviewed at any routine blood draw. Trend matters more than single-point values.

Standard panel inclusion

Annual for adults with diabetes, hypertension, cardiovascular disease, or family history of CKD. Reasonable every 2–3 years for healthy adults from age 40.

KDIGO 2024 · +1 more

Indicated when GH excess (acromegaly) or deficiency is suspected. Routine population screening of healthy adults not recommended.

Endocrine Society 2014 / 2019

Risk-stratified screening from age 50, earlier if specific risk factors (steroid use, premature menopause, prior fragility fracture).

NOGG 2021 (UK)

Class IIa for adults aged 40–75 at borderline-to-intermediate 10-year ASCVD risk (5–20%); particularly useful when decision-making about statin therapy is uncertain.

ACC/AHA 2018 · +2 more

Biennial screening for women 40–74 at average risk.

USPSTF 2024 · +2 more

Screening for adults 45–75; choice of FIT (annually), sigmoidoscopy + FIT, or colonoscopy (every 10 years if normal).

USPSTF 2021 · +2 more

Annual LDCT for adults 50–80 with ≥20 pack-year smoking history who currently smoke or quit within the past 15 years.

USPSTF 2021 · +1 more

One-time ultrasound for men in the year they turn 65.

NHS AAA Screening Programme · +1 more

Insufficient evidence for routine population screening of asymptomatic adults.

USPSTF 2023 · +2 more

Appropriate confirmatory study for uncomplicated suspected moderate-severe OSA. Not suitable for cases with significant comorbidity, suspected central apnea, or pediatric.

AASM 2017

Indicated when HSAT is inconclusive, when comorbidities or atypical presentations exist, for suspected central apnea, periodic limb movement disorder, parasomnias, or pediatric assessment.

AASM 2017

Class IIa for cardiovascular risk assessment in asymptomatic adults at intermediate risk where additional risk stratification would change management. Less emphasised in subsequent guidelines as coronary calcium has gained ground.

ACC/AHA 2010 · +2 more

Test annually in adults 60+; in younger adults, baseline value useful for tracking trajectory.

EWGSOP2 2019 · +1 more

Embedded in the Short Physical Performance Battery as a core test from age 60.

SPPB

The 10-second test is a useful single-point marker in adults 51+.

Araujo 2022

Standardised protocol for clinical and research use. Periodic monitoring useful when tracking rehabilitation progress.

ATS / ERS 2014

Reasonable annual self-tracking from age 30. Cohort evidence is strongest in middle-aged adults.

ACSM 2022

Daily morning measurement is the validated cadence; trends over 7-day rolling averages are what's actionable, not absolute single values.

HRV4Training validation · +1 more

Cardiorespiratory fitness should be considered a clinical vital sign; reasonable to assess (by estimation or formal test) at routine preventive visits.

AHA 2016 · +1 more

Track as a daily/weekly metric; trends matter more than single readings.

AHA 2016

Track over weekly rolling averages; identify patterns rather than fixating on single nights.

AASM 2015

Annual screening for adults 40+; every 3–5 years for adults 18–39 at low risk. Home or ambulatory confirmation before diagnosing hypertension.

USPSTF 2021 · +3 more

Useful at any age; track monthly when working on body composition, otherwise annually.

WHO 2008 · +1 more

Screen adults with risk factors for OSA — habitual snoring, witnessed apneas, daytime sleepiness, BMI > 35, treatment-resistant hypertension, atrial fibrillation.

AASM 2017 · +2 more

Used as part of OSA screening alongside STOP-Bang.

AASM 2017

Recommends screening for depression in all adults; instruments like PHQ-9 are the standard tool.

USPSTF 2023

Recommends screening for anxiety disorders in all adults aged 19–64.

USPSTF 2023

Used when cognitive concern is raised by patient, family, or clinician. Routine population screening of asymptomatic adults is not recommended.

ADA 2024 / Choosing Wisely

Used in clinical sleep evaluation and CBT-i outcomes tracking.

AASM 2014

Recommends screening for unhealthy alcohol use in adults aged 18+ with brief intervention for those at risk. AUDIT-C is the most-used screening instrument.

USPSTF 2018

Useful as a baseline and periodic re-measure during major life transitions (retirement, bereavement, relocation).

Common research / clinical practice

Initiate workup if STOP-Bang ≥3 or ESS ≥11 with consistent symptoms; HSAT acceptable for uncomplicated suspected moderate-severe OSA; PSG for ambiguous or comorbid cases.

AASM 2017

Measure at least once in all adults; repeat every 5 years if low-risk, more frequently if elevated.

ESC 2021 Prevention · +2 more

Optional addition to global risk assessment in intermediate-risk adults; repeat fasting if elevated to rule out transient cause.

AHA/CDC 2003 · +1 more

Screen for prediabetes/diabetes in adults 35–70 who are overweight or obese; every 3 years if normal.

USPSTF 2021 · +2 more

Routine screening of healthy adults not recommended; test those with risk factors (limited sun exposure, malabsorption, dark skin in high-latitude climates, osteoporosis).

Endocrine Society 2024 · +1 more

Test in adults with unexplained fatigue, reduced exercise capacity, restless legs, hair loss, or menstrual blood loss.

BSH 2021 · +1 more

Measure at least once in every adult's lifetime; reasonable in young adulthood. Repeat testing usually not needed.

ESC 2019 dyslipidaemia · +1 more

Reasonable to measure once as part of an extended cardiovascular workup; repeat if intervening on B12/folate.

B-vitamin guideline consensus

Consider when family history of T2D, PCOS, NAFLD, or abdominal obesity — particularly if HbA1c is still normal.

Endocrine consensus

Useful when investigating early insulin resistance; less helpful once diabetes is established.

Common practice

Part of standard lipid screening from age 40 (or earlier with risk factors).

ESC 2019 dyslipidaemia

Useful once to establish baseline; repeat 3–6 months after starting or stopping omega-3 supplementation.

Common practice

Annual creatinine + eGFR for adults with diabetes, hypertension, or known CKD. Reasonable every 2–3 years for healthy adults from age 40.

KDIGO 2024 · +1 more

Use cystatin C when creatinine-based eGFR is suspected to misclassify (extreme body composition, or borderline result).

KDIGO 2024

Routine screening from age 35, repeat every 5 years. Earlier or more frequent with risk factors (autoimmune disease, neck irradiation, pregnancy planning).

ATA 2014 · +1 more

Test alongside TSH when TSH is abnormal, or when central thyroid disease is suspected.

ATA 2014

Measure in men with consistent symptoms (low libido, fatigue, depressed mood, reduced muscle mass). Repeat for confirmation before treating.

Endocrine Society 2018 (men) · +1 more

Part of routine cardiovascular risk assessment from age 40.

ESC 2021

Part of routine cardiovascular risk assessment from age 40.

ESC 2021

Reported alongside LDL-C in modern panels.

ESC 2021

Screen for prediabetes and type 2 diabetes in adults 35–70 with overweight or obesity; every 3 years if normal.

USPSTF 2021 · +1 more

Evaluate persistently elevated ALT regardless of magnitude; investigate metabolic, alcohol, viral, and drug causes.

AASLD 2017 (Kwo) · +1 more

Helpful when characterising hepatobiliary patterns alongside ALT, AST, ALP. Routine isolated screening not recommended.

AASLD 2017 (Kwo)

Reviewed at any routine blood draw. Trend over years carries more signal than any single value.

Standard panel inclusion

Risk-adapted screening from age 50 (or 45 with family history / African ancestry). Multiparametric MRI before biopsy if PSA elevated.

EAU 2024 · +1 more

Test in adults with unexplained anaemia, macrocytosis, neurological symptoms, glossitis, or risk factors (vegan/vegetarian diet, metformin or PPI use, autoimmune conditions, prior gastrointestinal surgery).

BCSH 2014 (Devalia) · +1 more

Measure alongside B12 when investigating macrocytic anaemia, unexplained symptoms, or pre-pregnancy planning.

BCSH 2014

Order alongside ferritin when symptoms suggest iron deficiency despite normal ferritin, or when ferritin is elevated and overload is being considered.

BSH 2021

Reviewed at any routine blood draw. Trend matters more than single-point values.

Standard panel inclusion

Annual for adults with diabetes, hypertension, cardiovascular disease, or family history of CKD. Reasonable every 2–3 years for healthy adults from age 40.

KDIGO 2024 · +1 more

Indicated when GH excess (acromegaly) or deficiency is suspected. Routine population screening of healthy adults not recommended.

Endocrine Society 2014 / 2019

Screen women aged 65+; younger postmenopausal women with elevated fracture risk per FRAX.

USPSTF 2025 · +2 more

Class IIa for adults aged 40–75 at borderline-to-intermediate 10-year ASCVD risk (5–20%); particularly useful when decision-making about statin therapy is uncertain.

ACC/AHA 2018 · +2 more

Biennial screening for women 40–74 at average risk.

USPSTF 2024 · +2 more

Screening for adults 45–75; choice of FIT (annually), sigmoidoscopy + FIT, or colonoscopy (every 10 years if normal).

USPSTF 2021 · +2 more

Annual LDCT for adults 50–80 with ≥20 pack-year smoking history who currently smoke or quit within the past 15 years.

USPSTF 2021 · +1 more

One-time screening for men 65–75 who have ever smoked.

USPSTF 2019 · +2 more

Insufficient evidence for routine population screening of asymptomatic adults.

USPSTF 2023 · +2 more

Appropriate confirmatory study for uncomplicated suspected moderate-severe OSA. Not suitable for cases with significant comorbidity, suspected central apnea, or pediatric.

AASM 2017

Indicated when HSAT is inconclusive, when comorbidities or atypical presentations exist, for suspected central apnea, periodic limb movement disorder, parasomnias, or pediatric assessment.

AASM 2017

Class IIa for cardiovascular risk assessment in asymptomatic adults at intermediate risk where additional risk stratification would change management. Less emphasised in subsequent guidelines as coronary calcium has gained ground.

ACC/AHA 2010 · +2 more

Test annually in adults 60+; in younger adults, baseline value useful for tracking trajectory.

EWGSOP2 2019 · +1 more

Annual screening in adults 65+, or sooner with concern about falls or strength.

STEADI (CDC) · +1 more

Annual assessment in adults 65+; included in the sarcopenia diagnostic pathway.

EWGSOP2 2019 · +1 more

Part of the falls risk assessment in adults 65+.

STEADI (CDC) · +1 more

Standardised protocol for clinical and research use. Periodic monitoring useful when tracking rehabilitation progress.

ATS / ERS 2014

Reasonable annual self-tracking from age 30. Cohort evidence is strongest in middle-aged adults.

ACSM 2022

Daily morning measurement is the validated cadence; trends over 7-day rolling averages are what's actionable, not absolute single values.

HRV4Training validation · +1 more

Cardiorespiratory fitness should be considered a clinical vital sign; reasonable to assess (by estimation or formal test) at routine preventive visits.

AHA 2016 · +1 more

Track as a daily/weekly metric; trends matter more than single readings.

AHA 2016

Track over weekly rolling averages; identify patterns rather than fixating on single nights.

AASM 2015

Annual screening for adults 40+; every 3–5 years for adults 18–39 at low risk. Home or ambulatory confirmation before diagnosing hypertension.

USPSTF 2021 · +3 more

Useful at any age; track monthly when working on body composition, otherwise annually.

WHO 2008 · +1 more

Screen adults with risk factors for OSA — habitual snoring, witnessed apneas, daytime sleepiness, BMI > 35, treatment-resistant hypertension, atrial fibrillation.

AASM 2017 · +2 more

Used as part of OSA screening alongside STOP-Bang.

AASM 2017

Recommends screening for depression in all adults; instruments like PHQ-9 are the standard tool.

USPSTF 2023

Used when cognitive concern is raised by patient, family, or clinician. Routine population screening of asymptomatic adults is not recommended.

ADA 2024 / Choosing Wisely

Used in clinical sleep evaluation and CBT-i outcomes tracking.

AASM 2014

Recommends screening for unhealthy alcohol use in adults aged 18+ with brief intervention for those at risk. AUDIT-C is the most-used screening instrument.

USPSTF 2018

Useful as a baseline and periodic re-measure during major life transitions (retirement, bereavement, relocation).

Common research / clinical practice

Initiate workup if STOP-Bang ≥3 or ESS ≥11 with consistent symptoms; HSAT acceptable for uncomplicated suspected moderate-severe OSA; PSG for ambiguous or comorbid cases.

AASM 2017