Evidence map›Paper›PMID 37549434›Full record

Observational studyJournal of clinical anesthesia2023

Differences between patients in whom physicians agree versus disagree about the preoperative diagnosis of heart failure.

Reed W Kamyszek, Noah Newman, Jacqueline W Ragheb, Michael W Sjoding, Hyeon Joo, Michael D Maile, Ruth B Cassidy, Jessica R Golbus, Michigan Congestive Heart Failure Investigators, Milo C Engoren and 1 more

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of clinical anesthesia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 33% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Reed W KamyszekDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Noah NewmanDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Jacqueline W RaghebDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Michael W SjodingDepartment of Internal Medicine, Division of Pulmonary and Critical Care, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Computational Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, USA.
Hyeon JooDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Michael D MaileDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Ruth B CassidyDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Jessica R GolbusDepartment of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Michigan Congestive Heart Failure Investigators
Milo C EngorenDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Michael R MathisDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Computational Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, USA. Electronic address: mathism@med.umich.edu.
University of Michigan–Ann Arbor · US

Funding

Optimizing Clinician and AI Collaborations to Support Timely Management of Acute DyspneaR01HL158626 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Michael William Sjoding, Jenna Wiens · 2021 to 2026
$3.8M
Cardiac sURgery anesthesia Best practices to reduce Acute Kidney Injury (CURB-AKI)R01DK133226 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Michael Robert Mathis, Karandeep Singh · 2022 to 2026
$3.3M
SCH: Leveraging Clinical Time Series to Learn Optimal Treatment of Acute Dyspnea R01LM013325 · NLM · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SJODING, MICHAEL WILLIAM, WIENS, JENNA · 2019 to 2022
$935k
Early Diagnosis of Heart Failure: A Perioperative Data-Driven ApproachK01HL141701 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MATHIS, MICHAEL ROBERT · 2018 to 2022
$862k
MObile health interVention to INcrease activity in Heart Failure (MOVIN-HF)K23HL168220 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Jessica Rachel Golbus · 2023 to 2026
$730k
NHLBI NIH HHS K01 HL141701NHLBI NIH HHS K23 HL168220NHLBI NIH HHS L30 HL143700NHLBI NIH HHS R01 HL158626NIDDK NIH HHS R01 DK133226NLM NIH HHS R01 LM013325
6 · The paper itself

Abstract

STUDY

objectiveTo quantify preoperative heart failure (HF) diagnostic agreement and identify characteristics of patients in whom physicians agreed versus disagreed about the diagnosis.

designObservational cohort study.

settingPatients undergoing major non-cardiac surgery at an academic center between 2015 and 2019. PATIENTS: 40,659 patients undergoing major non-cardiac surgery, among which a stratified subsample of 1018 patients with and without documented HF was reviewed.

interventionsVia a panel of physicians frequently managing patients with HF (cardiologists, cardiac anesthesiologists, intensivists), detailed chart reviews were performed (two per patient; median review time 32 min per reviewer per patient) to render adjudicated HF diagnoses. MEASUREMENTS: Adjudicated diagnostic agreement measures (percent agreement, Krippendorf's alpha) and univariate comparisons (standardized differences) between patients in whom physicians agreed versus disagreed about the preoperative HF diagnosis. MAIN

resultsAmong patients with documented HF, physicians agreed about the diagnosis in 80.0% of cases (consensus positive), disagreed in 13.8% (disagreement), and refuted the diagnosis in 6.3% (consensus negative). Conversely, among patients without documented HF, physicians agreed about the diagnosis in 88.0% (consensus negative), disagreed in 8.4% (disagreement), and refuted the diagnosis in 3.6% (consensus positive). The estimated agreement for the 40,659 cases was 91.1% (95% CI 88.3%-93.9%); Krippendorff's alpha was 0.77 (0.75-0.80). Compared to patients in whom physicians agreed about a HF diagnosis, patients in whom physicians disagreed exhibited fewer guideline-defined HF diagnostic criteria.

conclusionsPhysicians usually agree about HF diagnoses adjudicated via chart review, although disagreement is not uncommon and may be partly explained by heterogeneous clinical presentations. Our findings inform preoperative screening processes by identifying patients whose characteristics contribute to physician disagreement via chart review. Clinical Trial Number / Registry URL: Not applicable.

Indexed as

Heart FailurePhysiciansCohort StudiesHumansCardiac risk assessmentDiagnostic agreementElectronic health recordHeart failureNon-cardiac surgeryPreoperative evaluation

Identifiers

PMID37549434
PMCPMC11221412
OpenAlexW4385603433

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.