Aims-To summarise and critically evaluate research conducted in the UK between 1962 and 1996, on the effectiveness and efficiency of the school entry medical (SEM) examination.
Methods-An electronic search of a large number of databases, in conjunction with a search of reference lists, and sources in the grey literature produced a total of 64 studies.
Only one overview and 16 primary studies met the review's broad inclusion criteria.
The results showed significant differences in the identification and referral of new and ongoing problems not only between the routine and selective SEM but also within the two types of SEM examination.
There were also large differences in the numbers of children selected for SEM examination.
No study included in the review defined either the methods or the criteria used to identify children as screen positive.
No study provided follow up of children after referral to estimate the positive predictive value or yield of the screening, or follow up of the whole cohort to identify false negative cases.
Conclusion-Data on the effectiveness and efficiency of both the routine and selective SEM examination in accurately identifying children with new or ongoing health problems are not available at the present time.
The studies reviewed here demonstrate the fragility of the evidence on which the school entry medical is based, and call into question the ethical basis of this programme.
Mots-clés Pascal : Exploration clinique, Santé, Ecole, Surveillance, Dépistage, Maladie, Evaluation performance, Revue bibliographique, Enfant, Homme, Médecine scolaire
Mots-clés Pascal anglais : Clinical investigation, Health, School, Surveillance, Medical screening, Disease, Performance evaluation, Bibliographic review, Child, Human, School medicine
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0229952
Code Inist : 002B30A01A2. Création : 11/09/1998.