Observational studyThe New England journal of medicine2015
Preoperative medical testing in Medicare patients undergoing cataract surgery.
Observational study in The New England journal of medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 45 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pragmatic Trial of an Electronic Health Record/Behavioral Economics Intervention to Reduce Pre-Operative Testing for Cataract Surgery
Comparing Two Normal Approaches to Procedural Sedation for Cataract Surgery: A Prospective, Feasibility Pilot Study
Cataract Oral vs IV Sedation Pilot RCT: A Non-inferiority Assessment of Perioperative Safety and Cognitive Recovery in Older Adults
Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 152 citations in OpenAlex.
- Addressing overuse of health services in health systems: a critical interpretive synthesis.Health research policy and systems · 2018Pooled it
- Guideline
- 3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology.Arquivos brasileiros de cardiologiaGuideline
- Algorithmic Identification of the Daily Primary Frontline Clinician during Inpatient Medicine Encounters Using EHR Audit Log Data.Applied clinical informatics · 2026Article
- Comorbidities in Age-Related Cataract: Epidemiological Burden and Public Health Implications.Vision (Basel, Switzerland) · 2026Review
- Artificial intelligence-enhanced ECG score for perioperative risk assessment in non-cardiac surgery.European heart journal. Digital health · 2026Article
- Practice Pattern Variability in the Use of Pulmonary Arterial Catheters in Cardiac Surgery.Journal of cardiothoracic and vascular anesthesia · 2025Observational
- From Routine to Risk: Medical Liability and the Legal Implications of Cataract Surgery in the Age of Trivialization.Journal of clinical medicine · 2025Review
- Patterns of Prescription Switching in a Uniform-Pricing System for Multi-Source Drugs: A Retrospective Population-Based Cohort Study.Healthcare (Basel, Switzerland) · 2025Article
- Using Electronic Health Records to Identify the Daily Primary Provider During Hospitalization.Critical care explorations · 2024Article
- Routine preoperative assessment for cataract surgery is a source of frustration for primary care providers.BMC health services research · 2024Article
- Survey on Findings and Utilization of Preoperative Chest Radiography in Ophthalmic Surgery.Journal of clinical medicine · 2024Article
- How often is prophylactic parastomal mesh placement performed after rectal resection without sphincter preservation? An analysis of German nationwide hospital discharge data among 41,697 patients.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Identifying Strategies to Reduce Low-Value Preoperative Testing for Low-Risk Procedures: a Qualitative Study of Facilities with High or Recently Improved Levels of Testing.Journal of general internal medicine · 2023Article
- Examining patient perspectives on low-value care: Findings from a survey on preoperative testing for cataract surgery.Journal of the American Geriatrics Society · 2023Article
- The incidence, risk factors, management and prognosis of postoperative systemic complications after ophthalmic surgery: a retrospective study at a tertiary, academic referral hospital over a decade.Annals of medicine · 2023Article
- Is there variation in utilization of preoperative tests among patients undergoing total hip and knee replacement in the US, and does it affect outcomes? A population-based analysis.BMC musculoskeletal disorders · 2022Article
- Anesthesia Care for Cataract Surgery in Medicare Beneficiaries.JAMA internal medicine · 2022Article
- Clinical Appropriateness of Telehealth: A Qualitative Study of Endocrinologists' Perspectives.Journal of the Endocrine Society · 2022Article
- Association Between the COVID-19 Pandemic and Disparities in Access to Major Surgery in the US.JAMA network open · 2022Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundRoutine preoperative testing is not recommended for patients undergoing cataract surgery, because testing neither decreases adverse events nor improves outcomes. We sought to assess adherence to this guideline, estimate expenditures from potentially unnecessary testing, and identify patient and health care system characteristics associated with potentially unnecessary testing.
methodsUsing an observational cohort of Medicare beneficiaries undergoing cataract surgery in 2011, we determined the prevalence and cost of preoperative testing in the month before surgery. We compared the prevalence of preoperative testing and office visits with the mean percentage of beneficiaries who underwent tests and had office visits during the preceding 11 months. Using multivariate hierarchical analyses, we examined the relationship between preoperative testing and characteristics of patients, health system characteristics, surgical setting, care team, and occurrence of a preoperative office visit.
resultsOf 440,857 patients, 53% had at least one preoperative test in the month before surgery. Expenditures on testing during that month were $4.8 million higher and expenditures on office visits $12.4 million higher (42% and 78% higher, respectively) than the mean monthly expenditures during the preceding 11 months. Testing varied widely among ophthalmologists; 36% of ophthalmologists ordered preoperative tests for more than 75% of their patients. A patient's probability of undergoing testing was associated mainly with the ophthalmologist who managed the preoperative evaluation.
conclusionsPreoperative testing before cataract surgery occurred frequently and was more strongly associated with provider practice patterns than with patient characteristics. (Funded by the Foundation for Anesthesia Education and Research and the Grove Foundation.).
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.