Perioperative medicine & outcomes
Comparative effectiveness of virtual versus in-person anaesthesiology consultations: the VIRTUAL retrospective cohort study
Authors' conclusion
Before moderate-to-high-risk noncardiac, non-orthopaedic elective surgery, the noninferiority of virtual vs in-person anaesthesiology consultation for major morbidity or mortality was inconclusive. Virtual care was noninferior for several secondary outcomes and associated with reduced carbon emissions.
Study context
- Population
- Adults aged ≥40 yr, ASA physical status ≥3, having elective, noncardiac, non-orthopaedic, moderate- to high-risk surgery, Ontario, Canada, October 2020–March 2022
- Participants
- 17,027 adults
- Exposure
- Virtual vs in-person preoperative anaesthesiology consultation
- Virtualn = 8,399
- In-personn = 8,628reference
- Outcome
- Major morbidity or mortality (noninferiority margin: upper 95% CI <1.10 on relative scale)
- Follow-up
- 90 days
Methodological detailstarget trial emulation, comparative effectiveness, noninferiority, instrumental variable and propensity score methods
- Target trial emulation
- Comparative effectiveness
- Noninferiority
- Instrumental variable and propensity score methods
Main finding
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Length of hospital stay, costs of care, and DAH90
- Noninferiority observed
Travel-attributable carbon emissions
- In-person care associated with estimated increase in g CO2 per visit (SD 17 200)
- 8618
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Comparative effectiveness of virtual versus in-person anaesthesiology consultations: the VIRTUAL retrospective cohort study. Br J Anaesth. Published 27 July 2026. doi:10.
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