Implementation of a software-based decision support tool for guideline-appropriate preoperative evaluation: a prospective agreement study
Authors' conclusion
Strict guideline adherence for clearance for surgery through digitalised decision support inadequately considered patients, clinical context.
Study context
- Population
- Adult ASA physical status 3–4 patients undergoing elective noncardiac surgery at a German university hospital
- Participants
- 204 participants
- Exposure
- Digital guideline support vs Standard approach
- Outcome
- Level of agreement on clearance for surgery between digital guideline support and the expert
Methodological detailssingle-centre, cross-over design
- Single-centre
- Cross-over design
Main finding
As reported in the abstract
Agreement with expert decision
| Group | Value | Cohen's kappa |
|---|---|---|
| Digital guideline support | 66.7% | 0.37 [interquartile range 0.26-0.48] |
| Standard approach | 67.6% | 0.31 [0.21-0.42] |
Value
Digital guideline support66.7%
Standard approach67.6%
Cohen's kappa
Digital guideline support0.37 [interquartile range 0.26-0.48]
Standard approach0.31 [0.21-0.42]
- Digital guideline support vs Standard approach: P = 0.6 — agreement fair in both
Observational data: associations, not effects.
Further findings
Patients cleared for surgery
| Outcome | Digital guideline support | Standard approach | Expert |
|---|---|---|---|
| Correct clearance (expert decision as benchmark) | 50.5% | 44.6% | — not stated in the abstract |
— not stated in the abstract
Incorrect decisions on additional examinations
- Digital guideline support incorrectly asked for additional examinations
- 31.4%
- Standard approach did not consider conditions justifying additional examinations before surgery
- 29.4%
Original publication
Implementation of a software-based decision support tool for guideline-appropriate preoperative evaluation: a prospective agreement study. Br J Anaesth. Published 5 July 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →