Adding Examples to the ASA-Physical Status Classification Improves Correct Assignment to Patients.

Area of Science:

• Anesthesiology
• Medical Classification Systems
• Patient Safety

Background:

• The American Society of Anesthesiologists (ASA)-Physical Status Classification System is widely used but has shown inconsistent assignments.
• Non-anesthesia-trained clinicians also utilize the ASA-Physical Status Classification System.
• The ASA introduced examples in 2014 to aid in correct classification.

Purpose of the Study:

• To evaluate the impact of ASA-approved examples on the accuracy of ASA-Physical Status Classification System assignments.
• To compare the effectiveness of these examples between anesthesia-trained and nonanesthesia-trained clinicians.

Main Methods:

• A web-based questionnaire study recruited anesthesia-trained and nonanesthesia-trained clinicians.
• Participants classified 10 hypothetical cases using only ASA-Physical Status Classification System definitions, and then again with the added examples.
• Performance was assessed by the number of correct ASA-Physical Status Classification System assignments.

Main Results:

• Both clinician groups showed significant improvement in correct ASA-Physical Status Classification System assignments when using the examples compared to definitions alone (P < 0.001).
• Nonanesthesia-trained clinicians demonstrated a greater improvement with the examples than anesthesia-trained clinicians.
• Initial disparities in scores between groups were eliminated with the use of examples.

Conclusions:

• The addition of ASA-approved examples significantly enhances the accuracy of ASA-Physical Status Classification System assignments.
• Examples improve classification consistency for both anesthesia-trained and nonanesthesia-trained clinicians.
• The ASA examples effectively bridge the gap in classification accuracy between different clinical groups.