Wellness Exams

The usefulness of physicals may depend on individual patient factors, as well as the specific tests and screenings included in the exam! Review the references posted for evidence regarding pre-participation physicals, general wellness “checkups,” and pre-admission testing.

RESOURCES

  • American College of Obstetricians and Gynecologists, Committee Opinion No. 702. (2017). Female athlete triad. Obstetrics & Gynecology, 129(6), e160–e167. doi:10.1097/AOG.0000000000002113
  • American Medical Society for Sports Medicine. (2014). Five things physicians and patients should question. Retrieved from http://www.choosingwisely.org/societies/american-medical-society-for-sports-medicine
  • American Society of Clinical Pathology (2013). Lab tests before surgery. Retrieved from https://www.choosingwisely.org/patient-resources/lab-tests-before-surgery/?highlight=preoperative%20test
  • Antonellis, P. & Silsbee, R. (2018).  Employment interview screening: Time to face the ink.  Journal of Business & Economic Policy, 5(4), 44-53.
  • Bernhardt DT, Roberts WO, et al. (2019). PPE: Preparticipation Physical Evaluation Monograph (5th ed). American Academy of Pediatrics. https://publications.aap.org/aapbooks/book/656/Preparticipation-Physical-Evaluation
  • Bonazza, N. A., Smuin, D., Onks, C. A., Silvis, M. L., & Dhawan, A. (2017). Reliability, Validity, and Injury Predictive Value of the Functional Movement Screen: A Systematic Review and Me-ta-analysis. The American Journal of Sports Medicine, 45(3), 725–732. https://doi.org/10.1177/0363546516641937
  • Chang, C., Putukian, M., Aerni, G., Diamond, A., Hong, G., Ingram, Y., Reardon, C. L., & Wolanin, A. (2020). Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement-Executive Summary. British journal of sports medicine, 54(4), 216–220. https://doi.org/10.1136/bjsports-2019-101583
  • Choosing Wisely. (2017). Health checkups: When you need them and when you don’t. Retrieved from http://www.choosingwisely.org/patient-resources/health-checkups 
  • Choosing Wisely (2020). American Academy of Pediatrics Recommendation on screening ECG for sports preparticipation examination. Retrieved from https://www.choosingwisely.org/clinician-lists/aapccs2-do-not-routinely-order-a-screening-ecg-as-part-of-a-sports-preparticipation-examination-in-asymptomatic-otherwise-healthy-patients-with-no-personal-or-family-history-of-cardiac-disease/?highlight=preparticipation%20
  • Czoski-Murray, C., Lloyd Jones, M., McCabe, C., Claxton, K., Oluboyede, Y., Roberts, J., Nicholl, J. P., Rees, A., Reilly, C. S., Young, D., & Fleming, T. (2012). What is the value of routinely testing full blood count, electrolytes and urea, and pulmonary function tests before elective surgery in patients with no apparent clinical indication and in subgroups of patients with common comorbidities: a systematic review of the clinical and cost-effective literature. Health Technology Assessment (Winchester, England), 16(50), i–159. https://doi.org/10.3310/hta16500
  • Drezner, J., O’Connor, F., Harmon, K., Fields, K., Asplund, C., Asif, I., . . . Roberts, W. (2017). AMSSM position statement of cardiovascular pre-participation screening in athletes: Current evidence, knowledge gaps, recommendations and future directions. British Journal of Sports Medicine, 51, 153–167. doi:10.1136/bjsports-2016-096781
  • Edwards, A. F., & Forest, D. J. (2018). Preoperative Laboratory Testing. Anesthesiology clin-ics, 36(4), 493–507. https://doi.org/10.1016/j.anclin.2018.07.002
  • Everard, E., Lyons, M., & Harrison, A. J. (2018). Examining the association of injury with the Functional Movement Screen and Landing Error Scoring System in military recruits under-going 16 weeks of introductory fitness training. Journal of Science and Medicine in Sport, 21(6), 569–573. https://doi.org/10.1016/j.jsams.2017.05.013
  • Hall, A., Pike, A., Patey, A., Mortazhejri, S., Inwood, S., Ruzycki, S., Kirkham, K., Mahoney, K., & Grimshaw, J. (2022). Barriers to reducing preoperative testing for low-risk surgical procedures: A qualitative assessment guided by the Theoretical Domains Framework. PloS one, 17(12), e0278549. https://doi.org/10.1371/journal.pone.0278549
  • Harmon, K., Clugston, J., Dec, K., et al. (2019). American Medical Society for Sports Medicine position statement on consensus on concussion in sport. British Journal of Sports Medicine. 53, 213-225.
  • Harmon, K., Zigman, M., & Drezner, J. (2015). The effectiveness of screening history, physical exam and ECG to detect potentially lethal cardiac disorders in athletes: A systematic review/meta-analysis. Journal of Electrocardiology, 48, 329–338. doi:10.1016/j.jelectrocard.2015.02.001
  • Lee, K. C., & Lee, I. O. (2021). Preoperative laboratory testing in elderly patients. Current opinion in anaesthesiology, 34(4), 409–414. https://doi.org/10.1097/ACO.0000000000001008
  • Legge, J., Burgess-Limerick, R., & Peeters, G. (2013). A new pre-employment functional capacity evaluation predicts longer-term risk of musculoskeletal injury in healthy workers: a prospective cohort study. Spine, 38(25), 2208–2215.
  • Mabry, J., Hickman, J., & Glenn, T. (2020).  Pre-employment screening best practices in the commercial Motor vehicle industry, National Surface Transportation Safety Center for Excellence, Report #20-UI-085. Blacksburg: VA
  • MacDonald, J., Schaefer, M., & Stumph, J. (2021). The Preparticipation Physical Evaluation. American Family Physician, 103(9), 539–546.
  • Mahmud N, Schonstein E, Schaafsma F, Lehtola MM, Fassier JB, Reneman MF, Verbeek JH.(2010). Pre‐employment examinations for preventing occupational injury and disease in workers. Cochrane Database of Systematic Reviews, Issue 12. Art. No.: CD008881. DOI: 10.1002/14651858.CD008881. Accessed 08 June 2022.
  • Maron, B. J., Friedman, R. A., Kligfield, P., Levine, B. D., Viskin, S., Chaitman, B. R., . . . Thompson, P. D. (2014). Assessment of the 12-lead electrocardiogram as a screening test for detection of cardiovascular disease in healthy general populations of young people (12–25 years of age). Journal of the American College of Cardiology, 64(14), 1479–1514. doi:10.1016/j.jacc.2014.05.006
  • Marshall, R. E., Milligan-Saville, J. S., Steel, Z., Bryant, R. A., Mitchell, P. B., & Harvey, S. B. (2020). A prospective study of pre-employment psychological testing amongst police recruits. Occupational medicine (Oxford, England), 70(3), 162–168. https://doi.org/10.1093/occmed/kqaa008
  • Mutter, O., Taylor, G. A., Grebenyuk, E., Kuo, L. E., & Sanserino, K. A. (2021). Utility of Routine Preoperative Laboratory Testing for Low-risk Patients in Ambulatory Gynecologic Sur-gery. Journal of minimally invasive gynecology, 28(5), 1033–1040.e1. https://doi.org/10.1016/j.jmig.2021.01.001
  • Roberts, W., Lollgen, H., Matheson, G., Royalty, A., Meeuwisse, W., Levine, B., . . . Pigozzi, F. (2014). Advancing the pre-participation physical evaluation: An ACSM and FIMS joint consensus statement. Clinical Journal of Sports Medicine, 24(6), 442–447. doi:10.1097/JSM.0000000000000168
  • Schaafsma, F.G., Mahmud, N., Reneman, M.F., Fassier, J.B. & Jungbauer, F.H.W (2016). Pre-employment Examinations for preventing injury, disease and sick leave in workers (review), Cochrane Database of Systematic Reviews, 1, Art. No.:CD008881
  • Shein, D., & Stone, M. (2017). The annual physical: Delivering value. The American Journal of Medicine. 30(5), 507-508. DOI: https://doi.org/10.1016/j.amjmed.2016.12.036
  • Siddaiah, H., Patil, S., Shelvan, A., Ehrhardt, K. P., Stark, C. W., Ulicny, K., Ridgell, S., Howe, A., Cornett, E. M., Urman, R. D., & Kaye, A. D. (2020). Preoperative laboratory testing: Implications of “Choosing Wisely” guidelines. Best practice & research. Clinical anaesthesiology, 34(2), 303–314. https://doi.org/10.1016/j.bpa.2020.04.006
  • Steffens, D., Ismail, H., Denehy, L., Beckenkamp, P. R., Solomon, M., Koh, C., Bartyn, J., & Pillinger, N. (2021). Preoperative Cardiopulmonary Exercise Test Associated with Postoperative Outcomes in Patients Undergoing Cancer Surgery: A Systematic Review and Meta-Analyses. Annals of surgical oncology, 28(12), 7120–7146. https://doi.org/10.1245/s10434-021-10251-3
  • Winkelmann, Z., & Crossway, A. (2017). Optimal screening methods to detect cardiac disorders in athletes: An evidence-based review. Journal of Athletic Training, 52(12), 1168–1170. doi:10.4085/1062-6050-52.11.24
  • Wise, S. (2020). Preparticipation Physical Evaluation: AAFP and Others Update Recommendations. Am Fam Physician, 101(11), 692-694.