The diagnostic yield of the first episode of a periodic health evaluation: a descriptive epidemiology study.
BACKGROUND
The benefits of a periodic health evaluation remain debatable. The incremental value added by such evaluations beyond the delivery of age appropriate screening and preventive medicine recommendations is unclear.


METHODS
We retrospectively collected data on a cohort of consecutive patients presenting for their first episode of a comprehensive periodic health evaluation. We abstracted data on new diagnoses that were identified during this single episode of care and that were not trivial (i.e., required additional testing or intervention).


RESULTS
The cohort consisted of 491 patients. The rate of new diagnoses per this single episode of care was 0.9 diagnoses per patient. The majority of these diagnoses was not prompted by patients' complaints (71%) and would not have been identified by screening guidelines (51%). Men (odds ratio 2.67; 95% CI, 1.76, 4.03) and those with multiple complaints at presentation (odds ratio 1.12; 95% CI, 1.05, 1.19) were more likely to receive a clinically relevant diagnosis at the conclusion of the visit. Age was not a predictor of receiving a diagnosis in this cohort.


CONCLUSIONS
The first episode of a comprehensive periodic health evaluation may reveal numerous important diagnoses or risk factors that are not always identified through routine screening.
Division of Preventive Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. kermott.cindy@mayo.edu
Cindy A
CA
Kermott
Carol S
CS
Kuhle
Stephanie S
SS
Faubion
Ruth E
RE
Johnson
Donald D
DD
Hensrud
Mohammad Hassan
MH
Murad
D000328:Adult; D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010808:Physical Examination; D011322:Primary Prevention; D012189:Retrospective Studies; D055815:Young Adult