TY - JOUR
T1 - Do Ophthalmologists, Anesthesiologists, and Internists Agree About Preoperative Testing in Healthy Patients Undergoing Cataract Surgery?
AU - Bass, Eric B.
AU - Steinberg, Earl P.
AU - Luthra, Rajiv
AU - Schein, Oliver D.
AU - Tielsch, James M.
AU - Javitt, Jonathan C.
AU - Sharkey, Phoebe D.
AU - Petty, Brent G.
AU - Feldman, Marc A.
AU - Steinwachs, Donald M.
N1 - Funding Information:
This work was supported by grant HS-06280 from theAgencyforHealthCarePolicyandResearch,Rock-ville,Md. Dr Bass also receivedsupportfromaGeorge MorrisPiersolTeachingandResearchScholarshipfrom theAmerican College of Physicians, Philadelphia, Pa. WethankSandyEzrine,MS,DianeBurkom,MA,and theircolleaguesatSurveyResearchAssociatesIne,Baiti-
Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 1995/10
Y1 - 1995/10
N2 - To assess variation in reported use of preoperative medical tests in patients undergoing cataract surgery and to identify factors that influence test use by different physician groups we performed a national survey of ophthalmologists, anesthesiologists, and internists. Participants included randomly selected members of American professional societies who provided care to one or more patients undergoing cataract surgery in 1991. Responses were obtained from 538 (82%) of 655 eligible ophthalmologists, 109 (76%) of 143 anesthesiologists, and 54 (44%) of 122 internists. Fifty percent of ophthalmologists, 40% of internists, and 33% of anesthesiologists frequently or always obtained a chest x-ray film, while 20% of ophthalmologists, 27% of internists, and 37% of anesthesiologists never obtained a chest x-ray film for patients being considered for cataract surgery who had no history of major medical problems (P<.01 for differences between ophthalmologists and the other groups). Similarly, 70% to 90% of ophthalmologists, 73% to 79% of internists, and 41% to 79% of anesthesiologists frequently or always obtained a complete blood cell count, electrolyte panel, and electrocardiogram, while 4% to 11% of ophthalmologists, 13% to 17% of internists, and 9% to 28% of anesthesiologists never obtained these tests for such patients. Many respondents (32% to 80%) believed tests were unnecessary but cited multiple reasons for obtaining tests (eg, medicolegal concerns and institutional requirements). Many physicians in each group viewed preoperative evaluations as screening opportunities or believed that one of the other two types of physicians “required” tests. We conclude that marked variation exists within and across physician specialties in the use and rationale for use of medical tests in patients undergoing cataract surgery.
AB - To assess variation in reported use of preoperative medical tests in patients undergoing cataract surgery and to identify factors that influence test use by different physician groups we performed a national survey of ophthalmologists, anesthesiologists, and internists. Participants included randomly selected members of American professional societies who provided care to one or more patients undergoing cataract surgery in 1991. Responses were obtained from 538 (82%) of 655 eligible ophthalmologists, 109 (76%) of 143 anesthesiologists, and 54 (44%) of 122 internists. Fifty percent of ophthalmologists, 40% of internists, and 33% of anesthesiologists frequently or always obtained a chest x-ray film, while 20% of ophthalmologists, 27% of internists, and 37% of anesthesiologists never obtained a chest x-ray film for patients being considered for cataract surgery who had no history of major medical problems (P<.01 for differences between ophthalmologists and the other groups). Similarly, 70% to 90% of ophthalmologists, 73% to 79% of internists, and 41% to 79% of anesthesiologists frequently or always obtained a complete blood cell count, electrolyte panel, and electrocardiogram, while 4% to 11% of ophthalmologists, 13% to 17% of internists, and 9% to 28% of anesthesiologists never obtained these tests for such patients. Many respondents (32% to 80%) believed tests were unnecessary but cited multiple reasons for obtaining tests (eg, medicolegal concerns and institutional requirements). Many physicians in each group viewed preoperative evaluations as screening opportunities or believed that one of the other two types of physicians “required” tests. We conclude that marked variation exists within and across physician specialties in the use and rationale for use of medical tests in patients undergoing cataract surgery.
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U2 - 10.1001/archopht.1995.01100100036025
DO - 10.1001/archopht.1995.01100100036025
M3 - Article
C2 - 7575255
AN - SCOPUS:0029143643
SN - 0003-9950
VL - 113
SP - 1248
EP - 1256
JO - Archives of ophthalmology
JF - Archives of ophthalmology
IS - 10
ER -