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Evidence summaries

School Entry Medical Examination (Sem)

School entry medical examination might possibly have no effect, although there is no evidence from controlled trials. Level of evidence: "D"

A systematic review 1 including 16 studies with a total of 17 995 subjects was abstracted in DARE. The studies included 1 RCT, 2 comparative studies, and 13 retrospective observational studies or audits. The rate of identification of problems by doctors varied dramatically. There were significant differences between studies in terms of the number of children selected for medical, the identification of new (range 8-45 routine examination versus 2-8 for selective examination) and ongoing problems, and the number of children referred (range 13-31% routine versus 20-33% selective) and recalled (range 4-50% routine vs. 48-58% selective). One study showed that selective examination (when the doctor only sees children with problems) consumed 23.3% more medical time than non-selective routine SEM. Another study concluded that selective SEM might be more expensive than routine SEM especially when immunization is included.

    References

    • Barlow J, Stewart-Brown S, Fletcher J. Systematic review of the school entry medical examination. Arch Dis Child 1998 Apr;78(4):301-11. [PubMed] [DARE]

Primary/Secondary Keywords