Validation of pre-operative patient self-assessment of cardiac risk for non-cardiac surgery: foundations for decision support

AMIA Annu Symp Proc. 2013 Nov 16:2013:931-8. eCollection 2013.

Abstract

Objectives: To better characterize patient understanding of their risk of cardiac complications from non-cardiac surgery and to develop a patient driven clinical decision support system for preoperative patient risk management.

Methods: A patient-driven preoperative self-assessment decision support tool for perioperative assessment was created. Patient' self-perception of cardiac risk and self-report data for risk factors were compared with gold standard preoperative physician assessment to evaluate agreement.

Results: The patient generated cardiac risk profile was used for risk score generation and had excellent agreement with the expert physician assessment. However, patient subjective self-perception risk of cardiovascular complications had poor agreement with expert assessment.

Conclusion: A patient driven cardiac risk assessment tool provides a high degree of agreement with expert provider assessment demonstrating clinical feasibility. The limited agreement between provider risk assessment and patient self-perception underscores a need for further work including focused preoperative patient education on cardiac risk.

Publication types

  • Comparative Study
  • Observational Study
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Data Collection
  • Decision Making, Computer-Assisted
  • Female
  • Heart Diseases* / etiology
  • Humans
  • Male
  • Middle Aged
  • Physicians
  • Postoperative Complications*
  • Preoperative Period
  • Prospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Self-Assessment*