SynthesisBJS open2020
Systematic review and narrative synthesis of surgeons' perception of postoperative outcomes and risk.
Synthesis in BJS open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pooled it
- Predictive accuracy of surgeon gestalt for adverse postoperative outcomes: systematic review.The British journal of surgery · 2025Pooled it
- Tourniquet use for people with peripheral arterial disease undergoing major lower limb amputations.The Cochrane database of systematic reviews · 2023Pooled it
- A Systematic Review and Narrative Synthesis of Risk Prediction Tools Used to Estimate Mortality, Morbidity, and Other Outcomes Following Major Lower Limb Amputation.European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery · 2021Pooled it
- Conceptualizing surgical ageism to address age-based discrimination.Updates in surgery · 2026Review
- Balancing Objectivity and Humanity: Ethical Challenges and Considerations in Surgical Candidacy Decisions.HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues · 2026Article
- Minimally Invasive Versus Open Total Hysterectomy: From Practice Variability to a Decision Algorithm.Life (Basel, Switzerland) · 2026Article
- Early postoperative factors associated with in-hospital mortality after emergency noncardiac surgery: A Japanese nationwide registry-based intensive care unit cohort study.Scientific reports · 2026Observational
- Challenges in shared decision-making about major lower limb amputation: the PERCEIVE qualitative study.BMJ open · 2026Observational
- AMPREDICT Mobility-4: A Novel Four Category Mobility Outcome Prediction Model for Patients Undergoing Vascular Amputation.European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery · 2025Article
- AMPREDICT MoRe: Predicting Mortality and Re-amputation Risk after Dysvascular Amputation.European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery · 2025Article
- Predicting outcomes following open abdominal aortic aneurysm repair using machine learning.Scientific reports · 2025Article
- Use of risk assessment tools in emergency general surgery: a cross-sectional survey of surgeons and trainees.Updates in surgery · 2025Article
- Using the Perspectives of Advanced Practice Providers to Design Strategies to Increase Engagement of Surgical Patients in Advance Care Planning.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Predicting Functional Outcomes Following Dysvascular Lower Limb Amputation: An Evidence Review of Personalizing Patient Outcomes.Physical medicine and rehabilitation clinics of North America · 2024Review
- Predicting inferior vena cava filter complications using machine learning.Journal of vascular surgery. Venous and lymphatic disorders · 2024Article
- Comment on: "Integrating Human Intuition into Prediction Algorithms for Improved Surgical Risk Stratification".Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Establishing the Patient Acceptable Symptom State in a Nonshoulder Hand and Upper Extremity Population for the QuickDASH and PROMIS UE Computer Adaptive Tests.The Journal of hand surgery · 2024Article
- Management of acute diverticulitis in Stage 0-IIb: indications and risk factors for failure of conservative treatment in a series of 187 patients.Scientific reports · 2024Article
- Long-term risk prediction after major lower limb amputation: 1-year results of the PERCEIVE study.BJS open · 2024Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe accuracy with which surgeons can predict outcomes following surgery has not been explored in a systematic way. The aim of this review was to determine how accurately a surgeon's 'gut feeling' or perception of risk correlates with patient outcomes and available risk scoring systems.
methodsA systematic review was undertaken in accordance with PRISMA guidelines. A narrative synthesis was performed in accordance with the Guidance on the Conduct of Narrative Synthesis In Systematic Reviews. Studies comparing surgeons' preoperative or postoperative assessment of patient outcomes were included. Studies that made comparisons with risk scoring tools were also included. Outcomes evaluated were postoperative mortality, general and operation-specific morbidity and long-term outcomes.
resultsTwenty-seven studies comprising 20 898 patients undergoing general, gastrointestinal, cardiothoracic, orthopaedic, vascular, urology, endocrine and neurosurgical operations were included. Surgeons consistently overpredicted mortality rates and were outperformed by existing risk scoring tools in six of seven studies comparing area under receiver operating characteristic (ROC) curves (AUC). Surgeons' prediction of general morbidity was good, and was equivalent to, or better than, pre-existing risk prediction models. Long-term outcomes were poorly predicted by surgeons, with AUC values ranging from 0·51 to 0·75. Four of five studies found postoperative risk estimates to be more accurate than those made before surgery.
conclusionSurgeons consistently overestimate mortality risk and are outperformed by pre-existing tools; prediction of longer-term outcomes is also poor. Surgeons should consider the use of risk prediction tools when available to inform clinical decision-making.
Indexed as
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.