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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.