Systematic review: the value of the periodic health evaluation.
BACKGROUND
The periodic health evaluation (PHE) has been a fundamental part of medical practice for decades despite a lack of consensus on its value.


OBJECTIVE
To synthesize the evidence on benefits and harms of the PHE.


METHODS
Electronic searches of such databases as MEDLINE and the Cochrane Library, review of reference lists, and hand- searching of journals through September 2006.


METHODS
Studies (English-language only) assessing the delivery of preventive services, clinical outcomes, and costs among patients receiving the PHE versus those receiving usual care.


METHODS
Study design and settings, descriptions of the PHE, and clinical outcomes associated with the PHE.


RESULTS
The best available evidence assessing benefits or harms of the PHE consisted of 21 studies published from 1973 to 2004. The PHE had a consistently beneficial association with patient receipt of gynecologic examinations and Papanicolaou smears, cholesterol screening, and fecal occult blood testing. The PHE also had a beneficial effect on patient "worry" in 1 randomized, controlled trial but had mixed effects on other clinical outcomes and costs.


CONCLUSIONS
Descriptions of the PHE and outcomes were heterogeneous. Some trials were performed before U.S. Preventive Services Task Force guidelines were disseminated, limiting their applicability to modern practice.


CONCLUSIONS
Evidence suggests that the PHE improves delivery of some recommended preventive services and may lessen patient worry. Although additional research is needed to clarify the long-term benefits, harms, and costs of receiving the PHE, evidence of benefits in this study justifies implementation of the PHE in clinical practice.
Boulware
L Ebony
LE
Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins School of Medicine, and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. lboulwa@jhmi.edu
Marinopoulos
Spyridon
S
Phillips
Karran A
KA
Hwang
Constance W
CW
Maynor
Kenric
K
Merenstein
Dan
D
Wilson
Renee F
RF
Barnes
George J
GJ
Bass
Eric B
EB
Powe
Neil R
NR
Daumit
Gail L
GL
D019317:Evidence-Based Medicine; D006801:Humans; D017063:Outcome Assessment, Health Care; D010808:Physical Examination / Q000592:standards*; D011314:Preventive Health Services / Q000592:standards*; D018570:Risk Assessment; D013997:Time Factors; D014481:United States