Abstract
Purpose
[email protected] is a web-based application that includes a smart computer-based self-assessment
preoperative questionnaire (PreQuest). [email protected] enables remote non-telephonic
preoperative assessment via a virtual visit. We aimed to determine if the American
Society of Anesthesiologists (ASA) physical status classification assigned by PreQuest
and virtual visit is comparable with that assigned by face-to-face assessment, and
to determine the accuracy of [email protected] in recording complementary preoperative
information.
Design
Prospective, observational, paired study.
Methods
This study was conducted in a tertiary teaching hospital. A total of 510 adult patients
scheduled for surgery were consecutively recruited. Of these, 220 patients were included
in the analysis of ASA grade agreement.
Findings
PreQuest and virtual visit showed higher predictive value than face-to-face assessment
in detecting patients with ASA grades 1 to 2. Face-to-face assessment showed the highest
rate of false negatives (ASA 3-4 misclassified as ASA 1-2), with a sensitivity of
44.2% versus 69.8% and 50% for PreQuest and virtual visit, respectively. Virtual visit
showed the highest agreement with the ASA grade assigned by a panel of experts (kappa
index 0.52, 95% confidence interval 0.15-0.89). PreQuest and virtual visit offered
a more comprehensive registry of anthropometric data, more detailed record of chronic
diseases condition, and more accurate registry of patients’ treatments (virtual visit
> PreQuest > face-to-face assessment).
Conclusions
The combined use of PreQuest and virtual visit offers a better performance in assigning
the ASA grade for non-complex patients and a more accurate and detailed record of
complementary information. This finding suggests the feasibility of [email protected] as
a tool for preoperative assessment.
Keywords
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Article info
Publication history
Published online: December 09, 2022
Publication stage
In Press Corrected ProofFootnotes
Conflict of Interest: None to report.
Funding: This work corresponds to phase 1 of the two-phase study “[email protected], an integral model for telematic POA,” which was funded by the Andalusian Regional Council of Health as a project of Innovation in Health; Resolution on June 22, 2018; PIN-0224-2018.
Identification
Copyright
© 2022 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
