ArticleAnesthesiology2016
Preoperative Laboratory Investigations: Rates and Variability Prior to Low-risk Surgical Procedures.
Article in Anesthesiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Inappropriate use of clinical practices in Canada: a systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Pooled it
- Association between model of anesthesiology care and outcomes after cataract surgery: a population-based cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Article
- Preoperative investigation practices for elective surgical patients: clinical audit.BMC anesthesiology · 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
- 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
- Frequency and costs of low-value preoperative tests for patients undergoing low-risk procedures in the veterans health administration.Perioperative medicine (London, England) · 2022Article
- Prevalence and Factors Associated With Low-Value Preoperative Testing for Patients Undergoing Carpal Tunnel Release at an Academic Medical Center.Hand (New York, N.Y.) · 2022Article
- Variability and Costs of Low-Value Preoperative Testing for Cataract Surgery Within the Veterans Health Administration.JAMA network open · 2021Article
- Article
- Observational
- Variability and Costs of Low-Value Preoperative Testing for Carpal Tunnel Release Surgery.Anesthesia and analgesia · 2019Article
- Measuring the frequency and variation of unnecessary care across Canada.BMC health services research · 2019Article
- An Evidence-Based Health Care Knowledge Integration System: Assessment Protocol.JMIR research protocols · 2019Article
- Physician Characteristics Associated With Ordering 4 Low-Value Screening Tests in Primary Care.JAMA network open · 2018Article
- Routine perioperative practices and postoperative outcomes for elective lumbar laminectomies.Journal of spine surgery (Hong Kong) · 2018Article
- Role of Patient- and Surgery-Specific Risk in Receipt of Outpatient Preoperative Testing.Perioperative care and operating room management · 2018Article
- Preoperative pulmonary function tests before low-risk surgery in Japan: a retrospective cohort study using a claims database.Journal of anesthesia · 2018Article
- Influence of Institution-Based Factors on Preoperative Blood Testing Prior to Low-Risk Surgery: A Bayesian Generalized Linear Mixed Approach.Computational and mathematical methods in medicine · 2017Article
Corrections and comments
- Commented on by
Authors and funding
10 authors.
Funding
Abstract
backgroundIncreasing attention has been focused on low-value healthcare services. Through Choosing Wisely campaigns, routine laboratory testing before low-risk surgery has been discouraged in the absence of clinical indications. The authors investigated rates, determinants, and institutional variation in laboratory testing before low-risk procedures.
methodsPatients who underwent ophthalmologic surgeries or predefined low-risk surgeries in Ontario, Canada, between April 1, 2008, and March 31, 2013, were identified from population-based administrative databases. Preoperative blood work was defined as a complete blood count, prothrombin time, partial thromboplastin, or basic metabolic panel within 60 days before an index procedure. Adjusted associations between patient and institutional factors and preoperative testing were assessed with hierarchical multivariable logistic regression. Institutional variation was characterized using the median odds ratio.
resultsThe cohort included 906,902 patients who underwent 1,330,466 procedures (57.1% ophthalmologic and 42.9% low-risk surgery) at 119 institutions. Preoperative blood work preceded 400,058 (30.1%) procedures. The unadjusted institutional rate of preoperative blood work varied widely (0.0 to 98.1%). In regression modeling, significant predictors of preoperative testing included atrial fibrillation (adjusted odds ratio [AOR], 2.58; 95% CI, 2.51 to 2.66), preoperative medical consultation (AOR, 1.68; 95% CI, 1.65 to 1.71), previous mitral valve replacement (AOR, 2.33; 95% CI, 2.10 to 2.58), and liver disease (AOR, 1.69; 95% CI, 1.55 to 1.84). The median odds ratio for interinstitutional variation was 2.43.
conclusionsResults of this study suggest that testing is associated with a range of clinical covariates. However, an association was similarly identified with preoperative consultation, and significant variation between institutions exists across the jurisdiction.
Indexed as
Identifiers
26825151What 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.