Preoperative laboratory testing: Implications of "Choosing Wisely" guidelines.


Journal

Best practice & research. Clinical anaesthesiology
ISSN: 1878-1608
Titre abrégé: Best Pract Res Clin Anaesthesiol
Pays: Netherlands
ID NLM: 101121446

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 02 04 2020
accepted: 07 04 2020
entrez: 27 7 2020
pubmed: 28 7 2020
medline: 2 6 2021
Statut: ppublish

Résumé

Preoperative laboratory testing is often necessary and can be invaluable for diagnosis, assessment, and treatment. However, performing routine laboratory tests for patients who are considered otherwise healthy is not usually beneficial and is costly. It is estimated that $18 billion (U.S.) is spent annually on preoperative testing, although how much is wasteful remains unknown. Ideally, a targeted and comprehensive patient history and physical exam should largely determine whether preprocedure laboratory studies should be obtained. Healthcare providers, primarily anesthesiologists, should remain cost-conscious when ordering specific laboratory or imaging tests prior to surgery based on available literature. We review the overall evidence and key points from the Choosing Wisely guidelines, the identification of potential wasteful practices, possible harms of testing, and key clinical findings associated with preoperative laboratory testing.

Identifiants

pubmed: 32711836
pii: S1521-6896(20)30025-2
doi: 10.1016/j.bpa.2020.04.006
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

303-314

Informations de copyright

Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Harish Siddaiah (H)

Department of Anesthesiology, LSU Health Shreveport, Shreveport, LA, USA. Electronic address: hbanga@lsuhsc.edu.

Shilpadevi Patil (S)

Department of Anesthesiology, LSU Health Shreveport, Shreveport, LA, USA. Electronic address: spati1@lsuhsc.edu.

Anitha Shelvan (A)

31 Mall Road, Suite#254, Burlington, MA 01805 USA. Electronic address: anithaanesth@outlook.com.

Kenneth Philip Ehrhardt (KP)

Department of Anesthesiology, LSU Health New Orleans, 1542 Tulane Ave, Room 659, New Orleans, LA, 70112, USA. Electronic address: ehrhardtken@gmail.com.

Cain W Stark (CW)

Medical College of Wisconsin, 8701 West Watertown Plank Road, Wauwatosa, WI, 53226, USA. Electronic address: cwstark@mcw.edu.

Kenneth Ulicny (K)

Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA. Electronic address: kulicn@lsuhsc.edu.

Sasha Ridgell (S)

Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA. Electronic address: sridg1@lsuhsc.edu.

Austin Howe (A)

Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA. Electronic address: ahowe1@lsuhsc.edu.

Elyse M Cornett (EM)

Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA. Electronic address: ecorne@lsuhsc.edu.

Richard D Urman (RD)

Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA. Electronic address: rurman@bwh.harvard.edu.

Alan D Kaye (AD)

Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, LSU Health Shreveport, 1501 Kings Highway, Shreveport LA, 71103, USA. Electronic address: akaye@lsuhsc.edu.

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