REVIEW OF SYSTEMS (ROS)

The review of systems is an inventory of body systems obtained by asking a series of questions in order to identify signs and/or symptoms that the patient may be experiencing or has experienced. The following systems are recognized:

• Constitutional (e.g., temperature, weight, height, blood pressure) 

• Eyes 

• Ears, nose, mouth, throat 

• Cardiovascular 

• Respiratory

• Gastrointestinal 

• Genitourinary 

• Musculoskeletal 

• Integumentary (skin and/or breast) 

• Neurological 

• Psychiatric

• Endocrine 

• Hematologic/Lymphatic 

• Allergic/Immunologic

There are three levels of ROS:

1. Problem pertinent, which inquires about the system directly related to the problem identified in the HPI. In the following example, one system—psychiatric—is reviewed:

• CC: Depression.

• ROS: Positive for appetite loss and weight loss of 5 pounds (gastrointestinal/constitutional).

2. Extended, which inquires about the system directly related to the problem(s) identified in the HPI and a limited number (two to nine) of additional systems. In the following example, two systems—constitutional and neurological— are reviewed:

• CC: Depression. 

• ROS: Patient reports a 5-lb weight loss over 3 weeks and problems sleeping, with early morning wakefulness

3. Complete, which inquires about the system(s) directly related to the problem(s) identified in the HPI plus all additional (minimum of 10) body systems. In the following example, 10 signs and symptoms are reviewed:

• CC: Patient complains of depression.

• ROS:

a. Constitutional: Weight loss of 5 lb over 3 weeks 

b. Eyes: No complaints 

c. Ear, nose, mouth, throat: No complaints 

d. Cardiovascular: No complaints 

e. Respiratory: No complaints 

f. Gastrointestinal: Appetite loss 

g. Urinary: No complaints 

h. Skin: No complaints 

i. Neurological: Trouble falling asleep, early morning awakening

j. Psychiatric: Depression and loss of sexual interest