Abstract
We compared serious and non-serious review of systems (ROS) complaints in the Emergency
Department (ED). There were 173 adults discharged from an urban county ED who were
administered a 56-item ROS identical to the ED chart ROS. Blinded review of ED charts
determined which ROS complaints were documented by clinicians and whether ROS complaints
were addressed by ED diagnostic testing or physical examination (PE). Mean differences
in proportions with 95% confidence intervals (CIs) between serious and non-serious
ROS complaints were: 1) For whether patients expected ROS complaints addressed in
the ED, 15.7% (95% CI 6.5–24.2); 2) For ROS complaints concomitantly noted on ED charts
by providers, 9.0% (95% CI 1.7–17.6); and 3) For whether provider-noted ROS complaints
were addressed by testing or PE, 21.2% (95% CI 4.2–38.3). Discharged ED patients expect
more of their serious ROS complaints to be addressed. More serious ROS complaints
are noted and addressed by ED providers, but most ROS complaints noted by providers
are not addressed.
Keywords
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References
- The rational clinical examination.JAMA. 2001; 286: 341-347
- Bates' guide to physical examination and history taking.6th edn. Lippincott, Philadelphia1995
- The review of systems: an important part of a comprehensive examination.Postgrad Med. 1982; 71: 151-158
- A randomized controlled trial of right-heart catheterization in critically ill patients.J Intensive Care Med. 1991; 6: 91-95
Article info
Publication history
Published online: May 20, 2008
Accepted:
November 16,
2006
Received in revised form:
August 17,
2006
Received:
May 13,
2005
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
