Evidence map›Paper›PMID 42092290›Full record

ArticleAmerican journal of surgery2026

Reliability of a rating rubric to assess quality of preoperative goals of care notes.

Caelie E Kern, Morgan P Cribbin, Kirstin M Piazza, Phoebe G Whiteside, Lindsay R Pelcher, Amanda D Peeples, Octavia K Goodman, Caroline F Pascal, Robert M Arnold, Kaitlyn M Shrake and 1 more

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Article in American journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Caelie E KernDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Morgan P CribbinDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Kirstin M PiazzaCenter for Healthcare Evaluation Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Phoebe G WhitesideCenter for Healthcare Evaluation Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.
Lindsay R PelcherCenter for Healthcare Evaluation Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Amanda D PeeplesCenter for Healthcare Evaluation Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.
Octavia K GoodmanCenter for Healthcare Evaluation Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.
Caroline F PascalCenter for Healthcare Evaluation Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.
Robert M ArnoldDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine, New York, NY, USA.
Kaitlyn M ShrakeDepartment of Medicine, University of Kentucky, Lexington, KY, USA.
Daniel E HallDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Center for Healthcare Evaluation Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. Electronic address: hallde@upmc.edu.

Funding

Vascular Surgery Research Training (VascTrain) ProgramT32HL098036 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Edith Tzeng · 2010 to 2026
$7.2M
HSRD VA I50 HX003201NHLBI NIH HHS T32 HL098036
6 · The paper itself

Abstract

backgroundHigh-quality preoperative goals of care (GOC) documentation should address prognosis, goals and values, treatment options, and justification of a preferred treatment option. A reproducible method for evaluating note quality is critical for quality improvement. We sought to adapt a pre-existing rating rubric for preoperative GOC documentation and evaluate its interrater reliability (IRR).

methodsWe analyzed preoperative GOC notes from frail Veterans considering elective outpatient surgery at 5 Veterans Affairs Medical Centers. IRR was assessed using percent agreement and Cohen's kappa across 4 domains and overall quality.

results215 notes (April 2022 - July 2023) were included. Cohen's kappa ranged from 0.66 to 0.91 with percent agreement of 80.1% to 94.0%. The pooled kappa across domains was 0.82, indicating substantial to almost perfect agreement.

conclusionsIterative refinement produced a reliable rubric with at least substantial IRR, supporting its use for independent rating and quality improvement. Domain-specific variability highlights opportunities for further rubric refinement and rater training.

Indexed as

DocumentationPatient Care PlanningPreoperative CareAgedElective Surgical ProceduresFemaleHumansQuality ImprovementReproducibility of ResultsUnited StatesDocumentation qualityFrailtyGoals of carePreoperative assessmentShared decision-makingSurgical palliative care

Identifiers

PMID42092290
PMCPMC13383673

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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.