Review of systems

Abbreviated commonly as ROS, review of systems, in medical history taking, is a way to go through any associated symptoms from related systems.

For example, a patient presenting with the chief complaint of shortness of breath, may have not just pulmonary symptoms, but other related symptoms such as palpitations, leg swelling, changes in appetite, chest pain, fever or chills etc.

What is ROS?

A ROS is an inventory of body systems obtained through a series of questions seeking to identify signs and/or symptoms which the patient may be experiencing or has experienced.

Medical history taking

What is reviewed in ROS?

For purposes of ROS, the following systems are recognized:

1. Constitutional symptoms (e.g., fever, weight loss)
2. Eyes
3. Ears, Nose, Mouth, Throat
4. Cardiovascular
5. Respiratory
6. Gastrointestinal
7. Genitourinary
8. Musculoskeletal
9. Integumentary (skin and/or breast)
10. Neurological
11. Psychiatric
12. Endocrine
13. Hematologic/Lymphatic
14. Allergic/Immunologic

Problem pertinent ROS

A problem pertinent ROS inquires about the system directly related to the problem(s) identified in the HPI. The patient's positive responses and pertinent negatives for the system related to the problem should be documented.

Extended ROS

An extended ROS inquires about the system directly related to the problem(s) identified in the HPI and a limited number of additional systems. The patient's positive responses and pertinent negatives for two to nine systems should be documented.

Complete ROS

A complete ROS inquires about the system(s) directly related to the problem(s) identified in the HPI plus all additional body systems. At least ten organ systems must be reviewed. Those systems with positive or pertinent negative responses must be individually documented. For the remaining systems, a notation indicating all other systems are negative is permissible. In the absence of such a notation, at least ten systems must be individually documented.

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