The diagnostic yield of the first episode of a periodic health evaluation: a descriptive epidemiology study (BMC Health Services Research)

Background: The benefits of a periodic health evaluation remain debatable. The incremental value addedby such evaluations beyond the delivery of age appropriate screening and preventivemedicine recommendations is unclear. Methods: We retrospectively collected data on a cohort of consecutive patients presenting for their firstepisode of a comprehensive periodic health evaluation. We abstracted data on new diagnosesthat were identified during this single episode of care and that were not trivial (i.e., requiredadditional testing or intervention). Results: The cohort consisted of 491 patients. The rate of new diagnoses per this single episode ofcare was 0.9 diagnoses per patient. The majority of these diagnoses was not prompted bypatients` 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 atpresentation (odds ratio 1.12; 95% CI, 1.05, 1.19) were more likely to receive a clinicallyrelevant diagnosis at the conclusion of the visit. Age was not a predictor of receiving adiagnosis in this cohort. Conclusion: The first episode of a comprehensive periodic health evaluation may reveal numerousimportant diagnoses or risk factors that are not always identified through routine screening.