The Periodic Physical Examination in Asymptomatic Adults
Authors: Sylvia K. Oboler
Journal: Annals of Internal Medicine (1989)

Diagnosis and Treatment1 February 1989The Periodic Physical Examination in Asymptomatic AdultsSylvia K. Oboler, MD, F. Marc LaForce, MDSylvia K. Oboler, MDSearch for more papers by this author, F. Marc LaForce, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-3-214 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe components of the periodic physical examination have been evaluated according to contemporary epidemiologic standards. For the asymptomatic, nonpregnant adult of any age, no evidence supports the need for a complete physical examination as traditionally defined. The efficacy for three screening procedures has been established: Blood pressure should be measured at least every 2 years; women more than 40 years of age should have a breast examination done by a physician annually; and sexually active women should have a pelvic examination and a Papanicolaou test at least every 3 years after two initial negative tests have been obtained 1 year apart. Because of the prevalence and morbidity of specific diseases, and the sensitivity and specificity of screening tests, several other maneuvers are recommended for screening asymptomatic adults, although the optimal frequency has not been determined experimentally. Weight should be measured every 4 years. Visual acuity should be tested annually in adults older than 60 years of age. To identify patients at high risk for melanoma, a complete skin examination should be done once. Hearing should be tested by audioscope annually in adults older than 60 years of age. Physicians should encourage patients to have annual dental visits. To identify valvular abnormalities requiring antibiotic prophylaxis, cardiac auscultation should be done at least twice in an adult. Men older than 60 years of age should have a yearly examination of the abdomen for the presence of aortic aneurysm. Although the other components of the complete physical examination may be important in establishing and maintaining the physician-patient relationship, they have not been shown to be effective screening maneuvers for asymptomatic disease....References1. FrameCarlson PS. A critical review of periodic health screening using specific screening criteria. Part 1: Selected diseases of respiratory, cardiovascular, and central nervous systems. J Fam Pract. 1975;2:29-36. MedlineGoogle Scholar2. FrameCarlson PS. A critical review of periodic health screening using specific screening criteria. Part 2: Selected endocrine, metabolic, and gastrointestinal diseases. 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CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Sylvia K. Oboler, MD; F. Marc LaForce, MDAffiliations: From the Veterans Administration Medical Center and University of Colorado School of Medicine, Denver, Colorado, and Genesee Hospital and University of Rochester School of Medicine, Rochester, New York. For current author addresses, see end of text. 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Cass, MDPhysical Examination of Asymptomatic Adults for ScreeningMark R. Goldstein, MD 1 February 1989Volume 110, Issue 3Page: 214-226KeywordsAntibiotic prophylaxisAuscultationBlood pressureEpidemiologyHearingHospital medicineMelanomaMorbiditySpecificityVisual acuity ePublished: 1 December 2008 Issue Published: 1 February 1989 Copyright & Permissions© 1989 American College of PhysiciansPDF downloadLoading ...