What are the four types of prevention? Primary prevention acts before disease, secondary prevention detects it early, tertiary prevention limits its complications, and quaternary prevention protects against unnecessary care. This glossary defines these concepts and sixteen other terms related to the prevention check-up and personalized health, in alphabetical order.

10-year risk

The 10-year risk is the probability, estimated by a validated score, that a person will experience a given health event within the next ten years. In cardiology, for example, SCORE2 estimates the risk of heart attack or stroke, fatal or not, in people aged 40 to 69, and SCORE2-OP in people aged 70 to 89. This figure is expressed as a percentage and compared with thresholds that depend on age; it guides how intensive prevention should be (lifestyle changes alone, treatment of cholesterol or blood pressure) without being a diagnosis. It is a population-based estimate applied to an individual: two people with the same score will not have the same story. Our article on 10-year cardiovascular risk explains how to read it.

Biomarker

A biomarker is a biological characteristic that can be measured objectively and that provides information about a state or process in the body: normal functioning, early disease, or response to treatment. Blood sugar, LDL cholesterol, blood pressure, and C-reactive protein are everyday examples in general practice. A single biomarker is never a diagnosis: it is interpreted in light of age, sex, medical history, and other measurements. So-called “omics” approaches, such as metabolomics, quantify several hundred of them simultaneously from a single sample, which makes it possible to build risk scores richer than standard lab panels. Our article on blood biomarkers explains which ones matter and why.

CNIL reference methodology (MR-004)

MR-004 is a reference methodology of the CNIL, the French data protection authority, adopted by deliberation No. 2018-155 of May 3, 2018. It governs the processing of personal data for research, study, or evaluation purposes in the health field that do not involve human participants, in particular the reuse of data already collected. An organization that complies with it does not need to request authorization case by case, provided it meets its requirements: informing each individual, right to object, a compliance commitment filed with the CNIL, registration of each project in the public directory maintained by the Health Data Hub, and exclusion of certain data such as the NIR (French social security number). Our security and data page explains how Sokrate applies this framework.

Four types of prevention

According to the World Health Organization, prevention is the set of measures aimed at avoiding or reducing the number and severity of diseases, accidents, and disabilities. Four types are distinguished. Primary prevention acts before disease appears: vaccination, diet, physical activity, quitting smoking. Secondary prevention seeks to identify a disease at an early stage, before or at the very start of symptoms: this is the domain of screening. Tertiary prevention limits the complications, relapses, and disability of an established disease: therapeutic patient education, rehabilitation. Quaternary prevention protects against unnecessary medical interventions (see Quaternary prevention). Mon bilan prévention falls mainly under the first two; organized screening illustrates secondary prevention.

Health data hosting (HDS)

HDS refers to the French certification for health data hosting providers (hébergeurs de données de santé), established by Article L1111-8 of the French Public Health Code and governed by Decree No. 2018-137 of February 26, 2018. Any organization that hosts personal health data on behalf of a professional or a facility must be certified by a body accredited by COFRAC (the French accreditation committee); the certificate is issued for three years, with annual audits. There are two scopes: physical infrastructure hosting and managed hosting services. For a patient or a company, the provider’s HDS certification is a baseline criterion, which does not replace GDPR obligations (information, consent, rights). Our security and data page describes how Sokrate’s data is hosted.

Health examination center (CES)

A health examination center (CES, centre d’examens de santé) is a French National Health Insurance (Assurance Maladie) facility that carries out the preventive health examination (EPS). There are “about a hundred” of them, spread across mainland France and Guadeloupe. You can go by invitation, by request to your health insurance fund (CPAM, or MSA for the agricultural scheme), or by contacting the center directly. The examination takes about two hours, fasting, and combines a medical questionnaire, lab tests (blood, urine), hearing and cardiorespiratory tests depending on your profile, then a medical consultation and information about your rights and the care pathway. CES centers give priority to people who are distant from the health system. Our article on the free health check from French National Health Insurance details access and content.

Interprofessional agreement (ACI)

The interprofessional agreement (ACI, accord conventionnel interprofessionnel) is the national contract signed on June 20, 2019 between French National Health Insurance and the unions representing the health professions to fund local health professional networks (CPTS). It sets four core missions, including prevention, and two optional missions, with funding in two parts: the operation of the CPTS and each mission undertaken, with a fixed portion and a variable portion based on results. Two amendments (2020 and 2021) supplemented it, the second adding the mission of responding to health crises. Locally, the ACI takes the form of a contract between the CPTS, the local health insurance fund (CPAM), and the regional health agency (ARS). We detail its missions and funding in our guide CPTS and the prevention mission.

Local health professional network (CPTS)

A CPTS (communauté professionnelle territoriale de santé) is a voluntary grouping of health professionals in the same area (doctors, pharmacists, nurses, midwives, physiotherapists, care facilities, and medico-social organizations) who organize themselves to coordinate their actions and structure patient care pathways. Provided for by Article L1434-12 of the French Public Health Code, it formalizes a health project submitted to the ARS and generally takes the form of a nonprofit association. Its funding is based on the ACI, with four core missions: access to care, multi-professional care pathways, local prevention initiatives, and response to health crises. Its prevention mission makes it a natural player in rolling out Mon bilan prévention. See our guide CPTS and the prevention mission.

Metabolic age

Metabolic age is an estimate of a person’s “biological” age calculated from their blood metabolomic profile, then compared with their chronological age. A positive gap signals a metabolic profile closer to that of older people; a negative gap, the opposite. Research on large cohorts, including the MileAge indicator published in 2026 in Alzheimer’s & Dementia, is studying its link with the risk of age-related diseases. It is neither a diagnosis nor an individual prediction, and it should not be confused with the “metabolic age” displayed by some bathroom scales, which is derived from an estimate of basal metabolic rate. Our article on metabolic age explains what it measures and what it does not.

Metabolomics

Metabolomics is the large-scale study of the small molecules produced by metabolism (lipids, amino acids, sugars, inflammation markers) present in a biological sample, most often blood. A single analysis simultaneously quantifies hundreds of molecules: the panel used in the UK Biobank cohort, for example, measures 249 metabolic biomarkers (Julkunen et al., 2023). Studies show that these profiles improve the estimate of 10-year risk for several diseases compared with standard risk factors alone. Metabolomics remains a tool for risk estimation and monitoring, not a diagnostic test. Our article on NMR metabolomics explains the method and its limitations.

Mon bilan prévention

Mon bilan prévention, France’s national prevention check-up program, is the prevention appointment offered by French National Health Insurance, “a time for discussion dedicated to preventive health,” available once per person at four key ages: 18–25, 45–50, 60–65, and 70–75. It lasts 30 to 45 minutes, is fully covered (100%) with no upfront payment, and can be carried out by a doctor, a midwife, a nurse, or a pharmacist. It takes place in three stages: a self-assessment questionnaire filled out beforehand, the choice of one or two priority topics, and the writing of a Personalized Prevention Plan sent to the regular doctor unless the patient objects. Its framework is set by the ministerial order of May 28, 2024. Our reference guide to the prevention check-up answers practical questions.

Motivational interviewing

Motivational interviewing is a person-centered counseling method, developed in the 1980s by psychologists William Miller and Stephen Rollnick, that aims to strengthen a person’s own motivation to change a behavior (smoking, alcohol, sedentary lifestyle, diet). Rather than trying to convince, the professional explores ambivalence, listens to the patient’s reasons, and helps them formulate their own goals. It is one of the skills covered in the voluntary Mon bilan prévention training modules offered by the EHESP (the French School of Public Health), along with “brief interventions.” It is particularly useful when drafting the Personalized Prevention Plan, where the choice of priorities belongs to the patient. See our article on the Personalized Prevention Plan.

Nuclear magnetic resonance (NMR)

Nuclear magnetic resonance (NMR) is a physical phenomenon: when placed in a strong magnetic field, certain atomic nuclei (hydrogen in particular) absorb and then re-emit a radio wave at a frequency characteristic of their chemical environment. In imaging, it gives MRI; in biology, NMR spectroscopy makes it possible to identify and quantify hundreds of molecules simultaneously in a blood sample, without specific reagents and in a highly reproducible way. It is the technology used for metabolomics in large cohorts such as UK Biobank to measure lipoproteins, fatty acids, amino acids, and inflammation markers in a single analysis. Our article on NMR metabolomics details how it works and the biomarkers measured.

Organized screening

An organized screening program is a national program that systematically invites a population defined by age to take an early detection test, before any symptoms appear. In France, there are three programs for cancer, overseen by the French National Cancer Institute (Institut national du cancer): breast cancer (women aged 50 to 74, mammogram every two years), colorectal cancer (women and men aged 50 to 74, fecal immunochemical test done at home), and cervical cancer (women aged 25 to 65, cytology test then HPV test). They are intended for people with no symptoms and no particular history; in case of high risk, individual follow-up replaces the program. Screening falls under secondary prevention. Our article on the prevention check-up at ages 45–50 explains how the check-up prepares you for it.

Personalized Prevention Plan (PPP)

The Personalized Prevention Plan (PPP) is the written document that concludes Mon bilan prévention: for one or two priority topics chosen with the patient, it sets out concrete goals and the actions to achieve them (screening appointment, vaccination, change of habit, referral to a professional or a local resource). It is written by the professional who carries out the check-up, based on the self-assessment questionnaire and the consultation, using an official template adapted to each age group. Together with the risk identification form, it is sent to the regular doctor unless the patient objects, to ensure follow-up. Our article on the Personalized Prevention Plan gives examples by age.

Preventive health examination (EPS)

The preventive health examination (EPS, examen de prévention en santé), formerly the French social security system’s “free health check” (bilan de santé gratuit), is an examination of about two hours carried out at a French National Health Insurance health examination center, fully covered (100%) with no upfront payment. It is intended for insured people aged 16 and over and their dependents, with priority given to people who are distant from the health system. It includes a medical questionnaire, tests adapted to your profile (blood draw, urinalysis, hearing and cardiorespiratory tests), and a medical consultation. It differs from Mon bilan prévention, a 30- to 45-minute consultation with a local professional; the two can be combined. Our article on the free health check compares the two programs.

Quaternary prevention

Quaternary prevention is the set of actions that protect a person from unnecessary or excessive care: overdiagnosis, overtreatment, tests with no expected benefit. The concept was proposed in 1986 by Belgian general practitioner Marc Jamoulle and added in 1999 to the international dictionary of WONCA (the World Organization of Family Doctors), which defines it as the action taken to identify a patient at risk of overmedicalization, to protect them from new medical interventions, and to suggest ethically acceptable alternatives. It is a reminder that a check-up or a screening test also has possible downsides (false positives, anxiety, cascades of tests) and that a good prevention plan also knows when not to prescribe. See Four types of prevention.

Regular doctor (médecin traitant)

The regular doctor (médecin traitant) is the doctor, most often a general practitioner (GP), whom each insured person registers with French National Health Insurance to coordinate their care pathway. They provide regular follow-up, keep the medical record, refer to specialists, and draw up the care protocol in the event of a long-term condition (ALD). Seeing a doctor outside this pathway leads to less favorable reimbursement, with exceptions (gynecologist, ophthalmologist, psychiatrist, emergency). In prevention, the regular doctor receives the Personalized Prevention Plan and the risk identification form after Mon bilan prévention, unless the patient objects, regardless of which professional carried out the check-up. Our article on the prevention check-up carried out by a doctor clarifies their role.

SCORE2

SCORE2 is the algorithm of the European Society of Cardiology (ESC), published in 2021 in the European Heart Journal, that estimates the 10-year risk of a fatal or non-fatal cardiovascular event in people aged 40 to 69 with no known cardiovascular disease or diabetes. It uses age, sex, smoking, systolic blood pressure, and cholesterol (total and HDL, from which non-HDL is derived), and comes in four versions according to risk regions in Europe; France is in the low-risk region. SCORE2-OP extends it to people aged 70 to 89. It relies on a handful of variables: metabolomics adds dozens more, which is the subject of active research. Our article on 10-year cardiovascular risk shows how to interpret it.

Self-assessment questionnaire

The self-assessment questionnaire is the questionnaire patients fill out themselves before Mon bilan prévention, to identify their risk factors and prepare for the consultation. There is an official version for each age group (18–25, 45–50, 60–65, and 70–75), available as a PDF on ameli.fr (the French National Health Insurance website) or to fill out online in Mon espace santé (France’s personal digital health record). The questions cover lifestyle habits (diet, physical activity, smoking, alcohol, sleep), mental health, sexual health, vaccinations, screening and, depending on age, menopause, hearing, vision, or falls. The professional uses the answers to prioritize one or two topics with the patient. Our article on the prevention check-up questionnaire describes it age by age.

Key takeaways

  • Four types of prevention: primary (avoid), secondary (screen), tertiary (limit complications), quaternary (avoid overmedicalization).
  • Mon bilan prévention (30 to 45 minutes, four key ages, four professions) and the preventive health examination (two hours at a center) are both fully covered (100%) and can be combined.
  • The Personalized Prevention Plan is sent to the regular doctor unless the patient objects.
  • Biomarkers, metabolomics, SCORE2, and metabolic age estimate risks; none of them makes a diagnosis.
  • HDS and MR-004 are the two French regulatory benchmarks for hosting and reusing health data.

What Sokrate lets you do

The Sokrate service prepares Mon bilan prévention online: an adaptive questionnaire filled out at home, a Personalized Prevention Plan signed by a doctor and sent to the regular doctor unless you object, and follow-up by a care coordination nurse. Data is hosted by an HDS-certified hosting provider in France. To get started, fill out the questionnaire; to understand the official program, read our guide to the prevention check-up.