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 practice.