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When randomisation is impossible and interventions should be given to those in need, the regression discontinuity design, if properly conducted, can provide a valuable evidence base for intervention effects.18�C23 Methods Participant enrolment for the MetS Management Programme managed by the NHIS All those insured through employment and those insured as self-employed or contractors of all ages, and their dependants aged 40?years or older may be enrolled for regular annual (mainly for blue-collar workers) or biennial  health screening examinations at a local hospital. The NHIS has been selecting participants for the MetS Management Programme who have at least one of the components of MetS every month since January 2012 based on recent health examinations reported the previous month by local hospitals (figure 1). MetS was defined by the NHIS criteria, which adopted the criteria published by the National [http://www.selleckchem.com/products/EX-527.html check details] Cholesterol Education Programme (NCEP)1 using the recommended cut-off for waist circumference in Koreans24 and additional body mass index (BMI) criteria  as follows: Abdominal obesity, a waist circumference ��90?cm in men and ��85?cm in women or a BMI ��25?kg/m2 Elevated triglycerides ��150?mg/dL Low high-density lipoprotein (HDL) cholesterol of   If they agreed to participate in a different health management programme being operated by a public health centre. If they were deceased, had emigrated, entered the military or were admitted into a special facility as reported in the NHIS beneficiary data at enrolment. Low-intensity interventions in the NHIS MetS Management Programme All enrollees received a leaflet explaining MetS and a letter notifying them of any elevated components of MetS. Additionally, a contact telephone number for participant support services was included (figure 1). Screened participants with MetS were labelled as the high-risk group and were referred for additional services; people without MetS were labelled as the low-risk group and were invited to contact their local NHIS office to request additional services. Approximately 300 trained personnel at the NHIS office contacted the high-risk group directly.