Related Experiment Videos
Usefulness of routine preoperative testing: a prospective single-observer study.
Srinivas Mantha1, Michael F Roizen, Jyostna Madduri
1Department of Anesthesiology and Intensive Care, Nizam's Institute of Medical Sciences, Hyderabad, 500082 India. smantha@satyam.net.in
Journal of Clinical Anesthesia
|February 22, 2005
Summary
Routine preoperative testing yielded minimal new benefits, with most tests being unindicated. Only diabetes screening showed potential usefulness, suggesting a need for larger studies to reduce unwarranted testing costs.
Area of Science:
- Medical Research
- Clinical Diagnostics
- Health Economics
Background:
- Preoperative testing is standard practice, but the utility of routine, unindicated tests remains debated.
- A tertiary-care center in South India performs 11 preoperative tests per patient.
Purpose of the Study:
- To evaluate the unrecognized usefulness of routine preoperative testing.
- To determine if current practices warrant further investigation in larger studies.
Main Methods:
- A prospective, observational study of 127 adult patients undergoing elective neurosurgery.
- Assessed whether indicated (based on computerized questionnaire) or unindicated tests influenced patient outcomes.
Main Results:
- Out of 1395 tests, 63.3% were unindicated. Unindicated tests prompted care changes less often (0.91%) than indicated tests (3.3%).
- Computerized screening effectively identified anemia, ECG abnormalities, and HIV. Diabetes screening showed potential utility; some unindicated tests led to non-beneficial echocardiography.
Conclusions:
- No previously unidentified benefits were found to justify the persistence of over 50% unindicated preoperative tests.
- Larger studies are needed to confirm findings and support recommendations to reduce unwarranted testing and associated healthcare costs.