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a reduced concentration. We do not know what happened to the cholesterol concentrations of the 100 patients who failed to complete follow up. The same error is present in the discussion, where the authors state that of the 10% shown to have high cholesterol concentrations, "64% showed a positive response." They did not, and subsequent calculations and assertions based on this premise are therefore unfounded. Secondly, the authors seemed to be ignoring the effects of random variation. In the abstract and the results section they stated that the mean fall in cholesterol concentration in the 78 patients who showed a positive response to intervention was 1 1 mmol/l. In their discussion they claimed that this response was the result of intervention, but equally logically one could claim that 43 (36%) of 121 patients found to have high cholesterol concentrations and followed up by an intervention programme must have finished up with the same or increased cholesterol concentrations. We are not told which, but it seems reasonable to conclude that up to one third of the patients may have increased their risk of coronary heart disease as a result of intervention designed to do the reverse. Finally, and again related to random variation, the authors ignored the important concept of regression to the mean. Subjects selected because they represent an extreme value in a distribution can be expected to have less extreme values on subsequent measurements. We stopped treating "high blood pressure" found at the initial consultation years ago and now monitor blood pressure over several months before deciding whether to treat. One would expect cholesterol concentrations to drop in this type of study even if intervention had no effect, and the use of a control group would be essential before attempting to make any statement about the efficacy of intervention. The upshot is that a study which looks superficially impressive is almost uninterpretable. It is unfortunate that these results were published in their present form given the current runaway enthusiasm for cardiovascular screening in general practice. The apparent highlights of the study have already been circulated widely in the general practice press, perhaps tempting other doctors to invest resources in an unproved programme.