Computerized model for preoperative risk assessment

Zuidema, Xander; Meesters, R.C. Tromp; Siccama, I.; Houweling, P. L.

doi:10.1093/bja/aer151

Cited by 22 publications

(16 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For instance, anesthetists in Europe have used web-based preoperative systems to minimize variability in preoperative testing patterns for years. 5 These programs, or other tools that reduce variability, may allow us to direct our ever-shrinking healthcare resources to where they are most needed.…”

Section: In Replymentioning

confidence: 99%

See 1 more Smart Citation

The Devil in the Details

Tsai

Black²

2012

Anesthesiology

View full text Add to dashboard Cite

chart may have major implications, because AFE is the second leading cause of maternal death in developed countries and near-miss morbidity is often a modifiable precursor. (Accepted for publication April 20, 2012.) In Reply:We thank Holck et al. for their interest in our publication and comments regarding our flow diagram guiding the management of amniotic fluid embolism. 1 The format of our case scenario was intended to be an overview of the presentation and management of amniotic fluid embolism, and the purpose of the flow chart was to serve as a very general educational guide toward management options. It was not meant to be a completely exhaustive algorithm of clinical analysis and treatment course.However, we appreciate the authors suggesting the possibility of using fibrinogen concentrate as a newer alternative blood product therapy. We acknowledge that there may be a benefit of rapid low-volume bolus administration when compared with the delay encountered to thaw fresh frozen plasma or cryoprecipitate. However, use of fibrinogen concentrate also relies on its availability. Neither our community-based obstetric unit nor our level I trauma university hospital has fibrinogen concentrate readily available, and we suspect the same may be true of many institutions. It is also important to recognize that the dose and timing of administration of alternative blood products remains controversial.2,3 As was discussed both in our case scenario and emphasized by Holck et al., the use of factor VII should only be considered in cases of hemorrhage refractory to other therapies due to the risk of embolic consequences. Caution should also likely be exercised for fibrinogen concentrate because larger prospective studies are needed to determine its clinical efficacy and safety. 3 Holck et al. are correct in stating that there is probably no flow chart that would direct every possible available therapy in managing the coagulopathy and the hemodynamic presentation of cases of amniotic fluid embolism. We would like to reemphasize the importance of having a transfusion protocol for massive obstetric hemorrhage, regardless of etiology. A multidisciplinary approach with specific guidelines outlining rapid, early, and aggressive intervention and resuscitation is likely to optimize maternal outcomes. 4,5

show abstract

Section: In Replymentioning

confidence: 99%

“…A multidisciplinary approach with specific guidelines outlining rapid, early, and aggressive intervention and resuscitation is likely to optimize maternal outcomes. 4,5 …”

mentioning

confidence: 99%

The Devil in the Details

Tsai

Black²

2012

Anesthesiology

View full text Add to dashboard Cite

show abstract

“…The system generates a pre-operative summary including the results of key risk scores and recommended patient management strategies. In a recent study, the overall anaesthetic risk computed by the system (cASA) was compared with the ASA score estimated (eASA) by anaesthesia caregivers, including anaesthetists, anaesthesia trainees, and physician assistants [39]. The evaluation involved a retrospective analysis of 14349 patient cases and found that the cASA score computed by the system compared favourably with that of estimated by anaesthesia caregivers (eASA), with an overall difference of 1.1% between the 2 scores.…”

Section: Oscar (Optimising Surgical Care and Assessment Record)mentioning

confidence: 99%

Managing complexity in pre-operative information management systems

Bouamrane

Mair

Tao

2011

Proceedings of the First International Workshop on Managing Interoperability and Complexity in Health Systems

View full text Add to dashboard Cite

Pre-operative assessment is composed of a set of clinical investigations that precede anaesthesia and surgery. Due to the vast scope of pre-operative assessment, the clinical domain knowledge potentially relevant for assessment is virtually limitless. For this reason, a generic pre-operative assessment has traditionally focused on identifying common allergies, cardiovascular and respiratory risks and pre-empting potential airway complications, such as difficult intubation during anaesthesia. Complex surgical procedures may require additional precautions or even have separate specific pre-operative protocols. This article contributes to a review of the complexity of pre-operative assessment processes. Although often approached from a clinical perspective, these have seldom been addressed specifically from an information elucidation and knowledge management perspective.

show abstract

“…Traditionally, preanaesthesia assessment is conducted by a health care provider via a face-to-face interview with the patient. Studies suggest that self-administration of digital assessment questionnaires is a feasible means of gathering medical information for preanaesthesia assessment [3][4][5][6][7][8][9][10][11][12]. Compared with in-person interviews, these digital selfassessment tools are associated with patient acceptance and satisfaction, reliability of information and improved efficiency of assessment [4,6,9].…”

Section: Introductionmentioning

confidence: 99%

PreAnaesThesia computerized health (PATCH) assessment: development and validation

et al. 2020

View full text Add to dashboard Cite

Background Technological advances in healthcare have enabled patients to participate in digital self-assessment, with reported benefits of enhanced healthcare efficiency and self-efficacy. This report describes the design and validation of a patient-administered preanaesthesia health assessment digital application for gathering medical history relevant to preanaesthesia assessment. Effective preoperative evaluation allows for timely optimization of medical conditions and reduces case cancellations on day of surgery. Methods Using an iterative mixed-methods approach of literature review, surveys and panel consensus, the study sought to develop and validate a digitized preanaesthesia health assessment questionnaire in terms of face and criterion validity. A total of 228 patients were enrolled at the preoperative evaluation clinic of a tertiary women’s hospital. Inclusion criteria include: age ≥ 21 years, scheduled for same-day-admission surgery, literacy in English and willingness to use a digital device. Patient perception of the digitized application was also evaluated using the QQ10 questionnaire. Reliability of health assessment questionnaire was evaluated by comparing the percentage agreement of patient responses with nurse assessment. Results Moderate to good criterion validity was obtained in 81.1 and 83.8% of questions for the paper and digital questionnaires respectively. Of total 3626 response-pairs obtained, there were 3405 (93.4%) concordant and 221 (6.1%) discrepant response-pairs for the digital questionnaire. Discrepant response-pairs, such as ““no/yes” and “unsure/yes”, constitute only 3.7% of total response-pairs. Patient acceptability of the digitized assessment was high, with QQ10 value and burden scores of 76 and 30%, respectively. Conclusions Self-administration of digitized preanaesthesia health assessment is acceptable to patients and reliable in eliciting medical history. Further iteration should focus on improving reliability of the digital tool, adapting it for use in other languages and incorporating clinical decision tools.

show abstract

Computerized model for preoperative risk assessment

Abstract: We showed that ASA scores estimated by a heterogeneous group of anaesthesia caregivers (anaesthetists, anaesthesia trainees, and physician assistants) could be mimicked by the cASA computed by our preoperative assessment system.

Cited by 22 publications

References 29 publications

The Devil in the Details

The Devil in the Details

Managing complexity in pre-operative information management systems

PreAnaesThesia computerized health (PATCH) assessment: development and validation

Contact Info

Product

Resources

About