Yield of review of systems in a self-administered questionnaire.
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.
Verdon
M E
ME
Department of Family and Community Medicine, University of California at San Francisco, USA.
Siemens
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003321:Cornell Medical Index; D003937:Diagnosis, Differential; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000706:statistics & numerical data*; D008875:Middle Aged; D015203:Reproducibility of Results