Related Experiment Video
Updated: Aug 10, 2025
Low-Cost Single-Port LoCoSP Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy
Published on: September 11, 2021
Definition of low-value care in a low-risk preoperative population: A scoping review
Josiane F John1,2, Ana Paula B S Etges1,3,4, Miriam A Z Marcolino1,4
1National Institute of Science and Technology for Health Technology Assessment (IATS)- CNPq/Brazil (project: 465518/2014-1), Porto Alegre, Brazil.
Insights
Low-value care in preoperative settings, particularly unnecessary screening tests for asymptomatic patients, leads to increased costs and delays. This review defines low-value care to improve surgical pathways and reduce waste.
Area of Science:
- Surgical Care
- Health Services Research
Background:
- Preoperative care presents a significant opportunity to reduce low-value care.
- Defining low-value care in this phase is crucial for research and cost reduction.
Purpose of the Study:
- To identify definitions of low-value care in the preoperative period for low-risk populations.
- To propose a framework for understanding low-value care and its consequences in this setting.
Main Methods:
- A scoping review of theoretical studies and peer-reviewed papers was conducted.
- Databases searched included MEDLINE, EMBASE, and SCOPUS.
- Definitions and consequences of preoperative low-value care were extracted and synthesized.
Main Results:
- Eleven conceptual studies were included, with four providing a general definition of low-value care.
- The most frequent example of low-value care was preoperative screening tests for asymptomatic patients (81% of studies).
- Consequences included false positives, psychological distress, increased costs, and surgical delays.
Conclusions:
- Integrating definitions of low-value care in low-risk surgery is essential.
- This approach supports de-implementation of unnecessary care and enhances surgical pathways.
Rationale:
Preoperative care is one of the main areas in which to address low-value care. A detailed definition of what low-value care is in this period of the surgical care journey paves the way for new scientific research, clinical improvements, and reduction of unnecessary costs in this field.
Aims And Objective:
To identify how low-value care in low-risk preoperative population has been defined in the scientific literature and propose a low-value care framework with potential consequences in this setting.
Methods:
Scoping review of theoretical studies and peer-reviewed papers, including reviews, commentaries, or expert opinions, were considered eligible for inclusion. The following databases were consulted: MEDLINE (via PubMed), EMBASE, and SCOPUS (from inception to July 24, 2021), using a structured search with the keywords "low value care", "clinical waste", "preoperative", and "elective procedures." Two independent reviewers performed study selection and data extraction. The definition of low-value care in the preoperative period and their consequences were described after extracting previous low-value care concepts and summarising the contents. Also, a visual framework was built with this information.
Results:
From 1519 publications identified in the initial searches, 22 underwent full-text assessment, and 11 conceptual studies were included in the review. A total of four studies (36%) presented a general low-value care definition, and all studies report some situations considered low-value care in the preoperative field of low-risk surgeries. The most common example of preoperative low-value care, listed in nine studies (81%), was having asymptomatic patients undergo screening tests before surgery. The main clinical and nonclinical consequences of low-value care in the preoperative phase included false-positive results from exams as well as psychological distress, increased costs, and delay in surgery.
Conclusions:
Revisiting and integrating previous definitions of low-value care in low-risk surgery into a scoping review is a starting point for de-implementing unnecessary care and promoting improvements in surgical pathways.
More Related Videos
05:39Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
07:14A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery
Published on: January 18, 2018
Related Concept Videos
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:21Planning Nursing Care I
01:30Cleaning, Sterilization, and Disinfection
Cleaning
The cleaning process usually involves using water with detergents or enzymatic cleaner and removing foreign material from objects and surfaces, including organic material such as body fluids or inorganic material like soil. Cleaning is performed before high-level disinfection and sterilization because foreign materials on the cover of the devices interfere with process...