Bmj Usa: Paper

The preparticipation physical examination for athletics: a systematic review of current recommendations

BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E170
  1. Peter J Carek, associate professor (carekpj{at},
  2. Arch Mainous III, professor
  1. Department of Family Medicine, Medical University of South Carolina, 9298 Medical Plaza Drive, Charleston, SC 29406
  1. Correspondence to: Peter J Carek


    OBJECTIVE: To examine the medical literature regarding the effectiveness of the preparticipation physical examination (PPE) in satisfying the basic requirements for medical screening.

    DESIGN: Medline database (1966 to August 2002) search using the terms “preparticipation physical examination” and “physical examination.”

    MAIN OUTCOME MEASURE: The United States Preventive Services Task Force (USPSTF) description of an effective screening test was used to determine whether the studies available provide evidence that the PPE satisfies the basic requirements for medical screening.

    RESULTS: 176 articles were identified. The articles did not specify the presence of a randomized control group, nor did they describe subjects who were inappropriately cleared or restricted. Therefore, false-positive and false-negative rates were not presented. As the accuracy of the screening test was not demonstrated, the PPE failed to satisfy one of the major requirements for an effective screening test.

    CONCLUSION: The PPE for athletes does not satisfy the basic requirements for medical screening as described by the USPSTF.


    • Funding None

    • Competing interests None declared

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