In the majority of health testing services, the results (mostly obtained on the day of testing) are reported to examinees after processing and editing that usually need 1 to 2 weeks with synthetic judgments attached. However those results sometimes include urgent data that suggest impending critical conditions. The criterion of data that should be urgently reported are expected to have been established in most of health test facilities as well as in hospitals. We reviewed the present situations of selecting urgent data in health testing facilities in our vicinity and tried to establish feasible standards for urgent reports referring to questionnaire response of physicians who receive our health test reports. The criterion for urgent report must be established practical in consideration of extra labor of laboratory personnel and extra cost of retesting and duplicating reports to physicians.

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Objective: To develop the new health practice index (HPI) for Japanese.
Methods: The cross-sectional analysis was conducted among 849 Japanese health check-up examinees of ages 24 to 81 years old in 1999. Their lifestyles were evaluated by questionnaire consisted of ten unhealthy practices : weight gain, habitual drinking, smoking, physical inactivities, unhealthy styles of eating, snack eating, high-fat meal, salty meal, shortage of sleep, and fail to brush one's teeth. Chi-square test and ROC analysis were performed to examine the association between these practices and diseases such as obesity, impaired glucose tolerance, hypertension, hyperlipidemia, low HDL cholesterolemia, hyperuricemia and liver dysfunction.
Results: As a result of chi-square test, weight gain, habitual drinking, smoking, physical inactivities, style of eating and teeth brushing showed significant relationship with lifestylerelated diseases. Furthermore, as a result of ROC analysis, the total number of unhealthy practices (Japanese Health Practice Index, JHPI) showed good performance to some of these diseases such as obesity, low HDL cholesterolemia and liver dysfunction.
Conclusions: We have developed and applied the new HPI for Japanese (JHPI) . Although further longitudinal studies are needed, this new index has the possibility of risk assessment of lifestylerelated diseases in Japan.

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Erythrocyte Sedimentation Rate testing (ESR) has long been used as a chronic inflammation marker. We evaluated the clinical usefulness of ESR with 20, 926 laboratory testing data obtained from a multiphasic health testing system. 1) ESR data were studied with 49 items of clinical chemistry, hematology and physiology. Only globulin and hemoglobin exhibited significant correlation (p>0.01) .
2) ESR exhibited a negative correlation with MCV, but HGB did not. 3) The estimated multiple regressive equation was Y=-2.2546×hemoglobin value (g/dl) +9.6238×globulin value (g/dl) +15.7124. 4) Globulin increased with age but hemoglobin did not clearly decrease with it. 5) When the health testing data were applied to the estimation formula, 168/20, 926 (0.80%) were out of the -11mm area of the ESR regression line, and their showed hypochromic and microcytic in many cases. The results indicated that decreased hemoglobin means accelerated ESR but the anemia cases showing abnormally-low shape factors in MCV and MCH did not fit this assumption.

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Main purposes of conducting multiphasic health testing include (1) confirmation of health: comprehensive evaluation of health, (2) detection of lifestyle-related diseases especially of cancers at their early stages, (3) establishing intra-individual fluctuation ranges for each test, (4) correction of lifestyle, mainly of its dietary and athletic aspects to prevent lifestyle-related diseases.
In the past, when the target diseases of multiphasic health testing were called“adult diseases”, (1) and (2) were the main purposes of conducting the tests. However, the concept of improving health has changed from the detection of aging phenomena to the correction of daily life habits and now the individual standard fluctuation ranges (3) are mandatory criterion for health testing to achieve effective instructions showing concretely how to correct undesirable lifestyle.
Analysis of each examinee's serial test data based on chronological observations of data helps physicians predict whether the fluctuations of data suggest the impending diseases or not and enables and frank discussions between physicians and their examinees which allow the examinees to realize how their lifestyles should be corrected. This should be the real goal of conducting health testing.
Observation of test data over one year shows that they often fluctuate reflecting the change of environmental factors: jobsites, home background, health conditions on the moment of having tests, habitually taking medicines and favorite foods.
Some representative cases are presented to show the ways to interpret each fluctuation of data. Cases chosen are all punctual annual repeaters who visited us for six years successively.

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