Systematic review: the value of the periodic health evaluation

Ann Intern Med. 2007 Feb 20;146(4):289-300. doi: 10.7326/0003-4819-146-4-200702200-00008.


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

Purpose: To synthesize the evidence on benefits and harms of the PHE.

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

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

Data extraction: Study design and settings, descriptions of the PHE, and clinical outcomes associated with the PHE.

Data synthesis: 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.

Limitations: 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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review
  • Systematic Review

MeSH terms

  • Evidence-Based Medicine
  • Humans
  • Outcome Assessment, Health Care
  • Physical Examination / standards*
  • Preventive Health Services / standards*
  • Risk Assessment
  • Time Factors
  • United States