A useful check-up is not a fixed list. A whole-body MRI in someone with no symptoms can throw up a great many incidental findings, so the real task is to choose the tests that can genuinely change a medical decision.
Would you like to take stock without piling up tests you do not need? Noria Health Hub can arrange a full check-up or a second medical opinion in Brussels, with a report within 24 h, coordinate your care where needed across more than 40 medical pathways in 48 h, then, if your medical condition allows, arrange surgery within 7 days.
Why we do not publish the detailed programme
Publishing a bare list of tests says nothing about how they were chosen. What matters is the decision rule: why one test is indicated, why another is ruled out, and in what order they should be carried out. Those are the rules we want to make explicit.
There is a second reason, and it matters more. The programme you will be given depends on your age, your sex, your history and the tests you have already had elsewhere. An assessment identical for everyone would not be an assessment, it would be a catalogue. Yours is given to you by name, in full, before you commit to anything.
What is prepared before you arrive
| Milestone | What is decided |
|---|---|
| D-21 | Online intake form and pre-assessment |
| D-14 | Risk stratification, review of your previous imaging, screening for the factors that compromise a preparation |
| D-12 | Individually signed justification of every irradiating examination, by the practitioner and in consultation with the referrer |
D = your arrival day in Brussels.
The speed comes above all from that preparation upstream. By the time you arrive in Brussels, the tests you need and the order they follow have already been settled, subject to anything new that emerges on the day itself.
Radiation: the dose has to be known
The radiation dose deserves to be stated plainly whenever an assessment includes irradiating imaging. We set it out alongside simple benchmarks, so that the exposure can be understood and discussed before the examination takes place.
| What you receive | Dose | Benchmark and source |
|---|---|---|
| An assessment built without cross-sectional imaging | 0 mSv | No irradiating examination, a design choice and not a saving |
| An assessment including low-dose chest imaging | 1 to 1.7 mSv | Less than the natural background received in a year in Belgium. RadiologyInfo and the American Association of Physicists in Medicine, 2023 |
| One transatlantic return flight | ≈ 0.1 mSv | German Federal Office for Radiation Protection |
| Natural background in Belgium, per year | 2.72 mSv | Joint Research Centre, European Commission |
| Average total dose in Belgium, per year | 4.3 mSv | Belgian federal nuclear control agency |
Any irradiating examination must be individually justified and signed. That is European law, Directive 2013/59/Euratom, Article 55, not a commercial option. In a person without symptoms, that justification must additionally rest on the guidelines of the relevant learned societies. In our organisation it happens before you arrive, not in front of the machine.
An assessment identical for everyone does not reduce mortality
This is the finding our whole way of working rests on, and it is an awkward one for the profession. The reference Cochrane review brought together the trials in which adults were randomly allocated between a general health check, the same for everyone, and no check at all. Of the 15 trials retained, 11 of them, covering 233,298 adults, measured mortality. The result is a relative risk of 1.00, with an interval running from 0.97 to 1.03. In other words, no difference, over follow-up ranging from 4 to 30 years.
That figure does not say a check-up is useless. It says that a check-up identical for everyone, offered without regard to age, history, risk factors and symptoms, does not change mortality. What has proved its worth is screening targeted at the people actually concerned. That is why we start from your situation and not from a ready-made list of tests.
The 4 rules we hold ourselves to
| The rule | Why it exists |
|---|---|
| No irradiating examination is added without an individually signed justification | A European obligation, and the only real safeguard against imaging for comfort |
| Sleep and colonoscopy are never recorded on the same night | A night of bowel preparation, or a night following sedation, produces a respiratory trace that would have to be qualified. Better not to produce it |
| No test requiring attention and cooperation is performed after sedation | Psychomotor recovery takes 2 to 4 hours. Breathing, hearing or visual field measured in that window are worthless |
| A dense debrief is never given on waking from sedation | It is written, and picked up again remotely at a follow-up point. Complex information is not reliably retained that day |
The tests we rule out as a matter of principle
Our rule is simple: if the result of a test cannot change any medical decision, that test has no place in the assessment. That rule sets aside several tests commonly offered in very broad assessments.
Whole-body imaging as routine screening is the clearest example. A review of 6,214 examinations in an asymptomatic population, distinct from the one quoted in our preventive assessment article, shows that 95% of subjects have at least one abnormality, that 30% require further investigation, and that 1.1% have a confirmed cancer. No randomised trial, no mortality data, no conclusive cost-effectiveness analysis in an asymptomatic person without risk factors. It is a powerful and demanding tool, not a reflex, and we offer it only where a precise reason justifies it.
And if your situation calls for a test the chosen format does not contain, we will tell you so, rather than sell you this one.
In practical terms, if this applies to you
If you want a clear picture without a pile of tests that lead nowhere, the documents you already hold can be studied before you arrive. In Brussels, the consultations and tests that are useful are grouped together, according to your situation, over 24 to 48 hours. The results are drawn together and the next steps are organised. Where a procedure is medically indicated, the surgical stage can be prepared with the aim of operating within 7 days of the check-up, when your medical condition allows.
Need a medical opinion quickly? For a worry that does not call for the emergency services, you can ask to speak to a doctor at any time through Noria Health Hub. This on-demand medical consultation is billed separately from the assessment pathway.
Further reading
The two companion articles to this one.
Who” rel=”noopener” target=”_blank”>https://noriahealth.com/blog/who-performs-your-examination-changes-what-it-finds/”>Who performs your examination changes what it finds
What” rel=”noopener” target=”_blank”>https://noriahealth.com/blog/what-delay-really-costs-what-the-studies-say/”>What delay really costs, what the studies say
Sources
Krogsbøll LT, Jørgensen KJ, Gøtzsche PC, General health checks in adults for reducing morbidity and mortality from disease, Cochrane Database of Systematic Reviews, 2019. https://doi.org/10.1002/14651858.CD009009.pub3″ rel=”noopener” target=”_blank”>https://doi.org/10.1002/14651858.CD009009.pub3″>https://doi.org/10.1002/14651858.CD009009.pub3
Zugni F et al., Whole-body magnetic resonance imaging in oncologically healthy individuals, Cancer Imaging, 2020. https://doi.org/10.1186/s40644-020-00315-0
Directive 2013/59/Euratom, basic safety standards for protection against the dangers arising from exposure to ionising radiation, Article 55, individual justification of medical exposures.
Royal Decree of 13 February 2020, Belgian transposition, documented individual justification of medical exposures.
RadiologyInfo.org, Radiation Dose from X-Ray and CT Exams, Radiological Society of North America. https://www.radiologyinfo.org/en/info/safety-xray
American Association of Physicists in Medicine, Lung Cancer Screening CT Protocols v6.0, 2023. https://www.aapm.org/pubs/ctprotocols/documents/lungcancerscreeningct.pdf
Joint Research Centre, European Commission, European Atlas of Natural Radiation, annual effective dose from natural environmental radiation.
Bundesamt für Strahlenschutz, Cosmic radiation during flights. https://www.bfs.de/EN/topics/ion/environment/air-soil/flight/flight_node.html
European Society of Gastrointestinal Endoscopy, Bowel preparation for colonoscopy, Guideline Update, 2019. https://www.esge.com/assets/downloads/pdfs/guidelines/2019_a_0959_0505.pdf