What physical exams should be performed at 6-month check-ups?

From the Guidelines

A 6-month check-up should include a thorough history and physical examination, with special attention to any signs of transformation, secondary malignancies, or other health concerns, as well as routine blood count and chemistry tests, according to the most recent guidelines 1. The physical exam should be performed every 6 months for the first 2 years, and then as needed, with a focus on detecting any potential health issues early on.

• The exam should include:
  • A thorough evaluation of all major body systems
  • Examination of the eyes, ears, nose, and throat
  • Auscultation of the heart and lungs
  • Palpation of the abdomen
  • Assessment of neurological development
  • Inspection of the skin for rashes or lesions
• Additionally, the healthcare provider should evaluate the patient's overall health and well-being, and address any concerns or questions the patient may have.
• It is also important to note that patients with a history of irradiation of the neck should have their thyroid function evaluated at 1,2, and 5 years, as recommended by the guidelines 1.
• The use of a checklist, such as the one provided for adult patients taking amiodarone 1, can help ensure that all necessary exams and tests are performed at the 6-month check-up. However, the most recent and highest quality study 1 should be prioritized when making decisions about physical exams at 6-month check-ups.

From the Research

Physical Exams at 6-Month Check-Ups

The following physical exams should be performed at 6-month check-ups:

• Vital signs, including:
  • Blood pressure 2
  • Temperature 2
  • Pulse rate 2
  • Respiratory rate 2
• Heart health checks, including:
  • Electrocardiogram (ECG) signals 3
  • Heart rate 3
  • Oxygen saturation (SpO2) 3
• Other physical exams, including:
  • Body temperature measurements 3
  • Systolic and diastolic blood pressure measurements 3

Considerations for Pediatric Patients

For pediatric patients, age-specific centile curves for blood pressure, heart rate, and respiratory rate should be used to assess vital signs 4. A web-based application can be used to input patient data and obtain centile and z-score information for vital signs 4.

Accuracy of Vital Sign Measurements

The accuracy of vital sign measurements using smartwatches and portable health devices has been studied, with results showing that these devices can be accurate for heart rate measurements, but may not meet accuracy guidelines for other vital sign measurements 5.

General Recommendations

Check-up examinations should include counseling, immunization, and physical examination according to the patient's age and gender 6. The U.S. Preventive Service Task Force (USPSTF) provides updated recommendations on preventive care measures, including screening for lung cancer with low-dose CT in patients aged 55 to 80 years with a smoking history of ≥30 pack years 6.