Study: Pre-Surgical Testing Lacks Evidence of Utility

While surgical patients are often subjected to batteries of preoperative tests to determine risks of complications, the value of those tests lacks evidence, according to a January 2014 research brief in the "Effective Health Care" series from the Agency for Healthcare Research and Quality.

The only procedure with enough evidence to draw a conclusion was cataract surgery. For that procedure the evidence suggests electrocardiograms, metabolic panels and complete blood counts are not associated with better clinical outcomes. Also, complications and deaths may occur more frequently among patients who undergo ad hoc testing rather than routine testing, though this finding is not well supported.

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For all other operations, evidence is insufficient to determine the value of the testing with regard to improved clinical outcomes, according to the report.

"Given the large number of patients undergoing elective surgery, there is a clear need to develop better evidence for when routine or per protocol testing improves patient outcomes and what the harms may be," the authors concluded, noting the wide variety of possible surgical procedures and comorbidities possible make this a challenging mandate.

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