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Yield of the screening review of systems: a study on a general medical service
T L Mitchell1, J L Tornelli, T D Fisher
1Department of Internal Medicine, University of Texas Medical Branch, Galveston.
Study Objective:
To determine the usefulness of screening reviews of the cardiopulmonary and gastrointestinal systems during medical admissions.
Design:
Case series.
Setting:
General internal medicine ward of a university hospital.
Patients:
550 consecutive medical patients were initially screened at admission. The authors excluded 265 patients with life-limiting medical conditions, and they studied 98 patients with no known cardiopulmonary disease and 207 patients with no known gastrointestinal disease.
Interventions:
Positive responses to screening systems review questions were evaluated using a standardized testing algorithm.
Main Outcome Measures:
Numbers of new diagnoses; potential for patient benefit.
Main Results:
The authors made 26 new diagnoses for 25 patients (95% confidence limits, 16 to 37 patients), two of whom may have gained years of life as a result.
Conclusions:
The absolute yield of the screening cardiopulmonary and gastrointestinal reviews of systems of 550 patients admitted to an internal medicine service of a university hospital was a new diagnosis in about 5% of patients. An estimate of the cost-effectiveness compares favorably with those of other accepted screening practices.
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