RT Journal Article
SR Electronic
T1 Yield of Review of Systems in a Self-administered Questionnaire.
JF The Journal of the American Board of Family
                Practice
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 20
OP 27
DO 10.3122/jabfm.10.1.20
VO 10
IS 1
A1 Verdon, Mary E.
A1 Siemens, Kelly
YR 1997
UL http://www.jabfm.org/content/10/1/20.abstract
AB Background: Family physicians frequently screen new patients with questionnaires that include a standard review of systems. The diagnostic yield of such questionnaires is unknown. Methods: We retrospectively compared results of 248 patient questionnaires with the clinicians' dictated medical record in a university-based family medicine practice. Any positive responses in the review of systems section were compared with the medical record to determine whether they resulted in a new diagnosis and a therapeutic maneuver. Results: The case-finding yield for the review of systems section as a whole was 10.5 percent. This yield compares favorably with other screening maneuvers in clinical practice. Individual questions had yields of 0.0 to 1.6 percent. The positive predictive value for a given yes response on the review of systems, defined as new diagnoses divided by total yes answers, was 3.3 percent. Conclusions: Compared with other case finding maneuvers in clinical practice, the review of systems questionnaire has a very acceptable yield. Its positive predictive value is low, however, and there are differences observed among physicians. Certain questions had a positive predictive value of 0.0 and could be deleted, which would produce a shortened review of systems section.