Perioperative medicine & outcomes
Differences between patients in whom physicians agree versus disagree about the preoperative diagnosis of heart failure
Authors' conclusion
Physicians usually agree about HF diagnoses adjudicated via chart review, although disagreement is not uncommon and may be partly explained by heterogeneous clinical presentations.
Study context
- Population
- Patients undergoing major non-cardiac surgery at an academic center, 2015–20191,018 reviewed
- Participants
- 40,659 patients
- Exposure
- Documented heart failure (HF) vs No documented HF
- Outcome
- Physician agreement on HF diagnosis
Methodological detailssingle-centre, stratified subsample chart review, Two chart reviews per patient by cardiologists, cardiac anesthesiologists, intensivists; median review time 32 min per reviewer per patient
- Single-centre
- Stratified subsample chart review
- Two chart reviews per patient by cardiologists, cardiac anesthesiologists, intensivists; median review time 32 min per reviewer per patient
Main finding
As reported in the abstract
Consensus positive
Disagreement
Consensus negative
- Estimated agreement, all 40,659 cases
- 91.1% (95% CI 88.3%-93.9%)
- Krippendorff's alpha (0.75-0.80)
- 0.77
Observational data: associations, not effects.
Further findings
Characteristics of disagreement vs agreement
- Patients with physician disagreement had fewer guideline-defined HF diagnostic criteria
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Differences between patients in whom physicians agree versus disagree about the preoperative diagnosis of heart failure. J Clin Anesth. Published 5 August 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →