An inter-district audit of the school entry medicalexamination in Cheshire

Systematic review of the school entry medical examination

“…9 12 13 19 Three studies showed that social and demographic characteristics appeared to influence the number of children selected, and both the number and type of problems identified 79 18 Many studies included in this review failed to provide any information concerning the characteristics of the school(s) in which the children being tested were located, and it was therefore difficult to assess the extent to which these factors might have influenced the outcome of the SEM examination.…”

“…No studies reported the frequency with which advice/reassurance was given and this may reflect the difficulty of extracting data from routine statistics, regarding this component of the SEM as an independent activity. Only five studies reported on the frequency of referrals,6 7 11 16 18and a further five studies reported on the frequency of recalls 67 12 14 18 Only three studies reported both the rate for referrals and recalls 6…”

“…Only five studies reported on the frequency of referrals,6 7 11 16 18and a further five studies reported on the frequency of recalls 67 12 14 18 Only three studies reported both the rate for referrals and recalls 67 18 The range for referrals was 13–31% of children who were screened at the routine SEM and 20–33% of children who were screened at the selective SEM.…”

“…7 12 14 18 Only three studies reported both the rate for referrals and recalls 67 18 The range for referrals was 13–31% of children who were screened at the routine SEM and 20–33% of children who were screened at the selective SEM. The range for recalls was 4–50% for the routine SEM and 48–58% for the selective SEM.…”

“…The wide variation in selection rate is likely to be explained by the use of widely differing selection criteria. An interdistrict audit of the SEM in Cheshire which examined this issue in more depth, showed that had the criteria for selection been based on the absence of a satisfactory three year check and/or parental concerns, 217 of the 491 children with new problems which were identified, would have been missed 18. A further prospective observational study of 82 routine SEM examinations in which 48 problems were detected in 37 children, examined what the impact would have been of a number of different selection criteria in terms of the number of children that would have been selected for SEM 17.…”