Multiphasic Screening

The term “multiphaisc” simply means that many laboratory tests are performed in an attempt to find abnormalities that are not readily apparent. Some multiphasic screening programs involve fifty or more tests, including blood studies, urinalysis, X rays, electrocardiograms, and other procedures. With automation, these tests can be performed quickly and economically.

Experience with these screening systems over the years has shown that many laboratory abnormalities are detected but surprisingly few major problems that need attention are found. No laboratory test is perfectly accurate, and each test has a certain number of “false positives” associated with it. There is danger that the doctor may feel obligated to follow up the “false positive” test with additional tests, thereby unnecessarily increasing both the patient’s cost and worries.

Because of these problems, we do not routinely recommend multiphasic screening except as part of a total health care program, such as the Kaiser-Permanente
Health Plans. In such programs, multiphasic screening has allowed more effective use of nurse practitioners and has encouraged more efficient health care delivery systems. Some physicians also feel that multiphasic screening is an effective way to reassure the “worried well.” That is, a negative multiphasic screening examination may help people who are overly concerned about their health to accept the fact that medical treatment is not likely to help them with their problems. Thus, like the complete physical examination, multiphasic screening may be of value not so much for the detection of disease as for providing a good opportunity for reassurance and counsel.

Screening for disease detection is justified only for those individual tests that can detect important and treatable problems. For many people, the blood pressure measurement is by far the most important test.