Man against the machine - Differences in surgical risk evaluation. A cohort prospective study

Area of Science:

• Anesthesiology
• Surgical Risk Assessment
• Health Informatics

Background:

• Preoperative risk assessment is crucial for surgical outcomes.
• The American College of Surgeons (ACS) Surgical Risk Calculator offers a standardized tool for risk evaluation.
• Comparing calculator-based assessments with physician expertise is vital for improving patient safety.

Purpose of the Study:

• To compare the risk assessments of the ACS Surgical Risk Calculator with those of senior and resident anesthesiologists.
• To evaluate the accuracy of different methods in predicting surgical complications.
• To identify discrepancies in risk estimation between a computational tool and clinical judgment.

Main Methods:

• Prospective, controlled study involving 100 surgical patients.
• Data collection for pre-operative assessment by resident anesthesiologists.
• Risk assessment performed by resident and senior anesthesiologists, and the ACS Surgical Risk Calculator.
• Comparison of the three risk assessment methods.

Main Results:

• Significant differences observed among the ACS calculator, senior, and resident anesthesiologist assessments.
• Resident anesthesiologists' estimations more closely aligned with the ACS calculator than senior anesthesiologists' in most parameters.
• Discrepancies noted in predicting complications, life-threatening events, death, infections, and specific conditions like pneumonia.

Conclusions:

• Both senior and resident anesthesiologists demonstrated limitations in estimating surgical risks from preoperative data.
• The ACS Surgical Risk Calculator provided different risk profiles compared to anesthesiologists' assessments.
• Further research involving surgeons and actual complication rates is recommended to refine risk prediction models.