Twelve series with 20,047 adolescents were included: 3 routine physical examinations (7,953 adolescents) and 9 presports examinations (12,094 adolescents).
Routine school examinations: 3 series with 7,953 adolescents.
No serious abnormalities were detected. The percentage of adolescents referred for further testing varied from 3.8 to 4% in the study described as the most detailed evaluation (985 adolescents), but most of the abnormalities were already known. Minor conditions revealed by screening included acne, reduced visual acuity, short stature, obesity and dental caries. Prevalence rates for individual conditions were as follows: increased blood-pressure, 0 to 0.4% in males and 0.2% in females; abnormal heart disease, 0.2% congestive heart disease and 0.7% rheumatic heart disease; abnormal heart murmur, 0.5% in males and 1.0% in females; hernia, 0 to 0.3%; undescended testis, 0 to 0.5%; and serious positive findings, 4% known before examination for one study, 3.8% unknown before examination for another study and not stated for the third study.
Presports examinations: 9 series with 12,094 adolescents.
Two major previously undetected abnormalities, i.e. one mitral valve insufficiency and one unilateral blindness, were found. The percentage of adolescents referred for further testing varied from 1.2 to 13.5%. All the students in the study reporting the highest referral rate were eventually allowed to participate in sports.
Minor orthopaedic problems were found in 1.8 to 16.8% of the students, with higher rates found when orthopaedic residents or physical therapists performed the examinations. The most frequent medical finding was a heart murmur that proved to be unimportant, or some previously known congenital heart defects. The definition of hypertension varied and rates of hypertension (across 4 series) ranged from 0.1 to 1.6%.
Several factors were thought to limit the usefulness of the review: examinations were performed by different physician and paramedical teams; some examinations were conducted by individual physicians whilst others used the team or station approach; the definition of abnormality varied across studies; and most examinations were performed in students interested in participating in sports, and thus may not representative of the age-group.