Yield of the screening review of systems: a study on a general medical service.

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.