Division of Preventive Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
BMC Health Serv Res. 2012 May 30;12:137. doi: 10.1186/1472-6963-12-137.
The benefits of a periodic health evaluation remain debatable. The incremental value added by such evaluations beyond the delivery of age appropriate screening and preventive medicine recommendations is unclear.
We retrospectively collected data on a cohort of consecutive patients presenting for their first episode of a comprehensive periodic health evaluation. We abstracted data on new diagnoses that were identified during this single episode of care and that were not trivial (i.e., required additional testing or intervention).
The cohort consisted of 491 patients. The rate of new diagnoses per this single episode of care was 0.9 diagnoses per patient. The majority of these diagnoses was not prompted by patients' complaints (71%) and would not have been identified by screening guidelines (51%). Men (odds ratio 2.67; 95% CI, 1.76, 4.03) and those with multiple complaints at presentation (odds ratio 1.12; 95% CI, 1.05, 1.19) were more likely to receive a clinically relevant diagnosis at the conclusion of the visit. Age was not a predictor of receiving a diagnosis in this cohort.
The first episode of a comprehensive periodic health evaluation may reveal numerous important diagnoses or risk factors that are not always identified through routine screening.
定期健康评估的益处仍存在争议。这种评估除了提供年龄相关的筛查和预防医学建议之外，其增加的额外价值尚不清楚。
我们回顾性地收集了一组连续就诊患者的资料，这些患者都进行了首次全面定期健康评估。我们从单次就诊护理中提取到新诊断的数据，这些新诊断并非微不足道（即需要进一步检查或干预）。
该队列包括 491 名患者。在单次就诊中，每位患者的新诊断率为 0.9 个诊断。这些诊断中的大多数并非由患者的主诉引起（71%），也不会被筛查指南识别（51%）。男性（优势比 2.67；95%置信区间，1.76，4.03）和就诊时存在多种主诉的患者（优势比 1.12；95%置信区间，1.05，1.19）更有可能在就诊结束时得到有临床意义的诊断。在该队列中，年龄并不是诊断的预测因素。
全面定期健康评估的首次就诊可能会揭示许多重要的诊断或风险因素，而这些因素并不总是通过常规筛查来识别。
