Preoperative testing is often unnecessary for low-risk surgeries, but remains common practice at many hospitals in Michigan, according to a study published May 17 in JAMA Internal Medicine.
Mounting evidence shows such testing is expensive and doesn't usually improve patient outcomes. In the worst-case scenario, it can even spur more invasive testing or surgical delays, according to researchers at the University of Michigan in Ann Arbor.
They analyzed claims data on about 40,000 patients who had surgery to remove the gallbladder, fix a groin hernia or remove cancerous breast tissue. The surgeries were at 63 Michigan hospitals between Jan. 1, 2015, and June 30, 2019.
About half of patients received at least one preoperative test, and 29.4 percent had at least two, researchers found. The most common tests were a basic metabolic panel, complete blood count and electrocardiogram.
Patients who had a complete physician and medical history taken during visits billed separately were more likely to undergo preoperative testing, along with patients who were older or had multiple comorbidities. Researchers also saw wide variation in testing across the 63 hospitals and still found an overuse of testing even after adjusting their model to account for patients who might have benefited from the tests.
"There aren't that many areas in medicine where the data is pretty definitive that something is low-value, but preoperative testing before low-risk surgeries is certainly one of them," said Lesly Dossett, MD, division chief of surgical oncology at Ann Arbor-based Michigan Medicine and co-director of the university's Michigan Program on Value Enhancement, which helped conduct the research.