Abstract
HealthQuiz II (HQII) is a computerized historytaking device which can be used by patients before anaesthesia and surgery. HealthQuiz II provides a summary of symptoms, a modified ASA Classification, and a list of suggested laboratory tests. Developed at the University of Chicago, the device has not been evaluated in Canada. The purpose of this study was to compare preoperative evaluation and selection of laboratory tests by a group of Canadian anaesthetists using traditional methods versus using HealthQuiz II. Twenty- seven anaesthetists from three (Western) Canadian University teaching hospitals participated in the study. The subjects were male, aged between 30–50 yr, trained in Canada and practicing in Calgary, Edmonton and Vancouver. They were asked to self- evaluate and select laboratory tests and then to complete the HQII protocol, the day before a proposed mock operation. Results of this comparison showed that the ASA scores assigned by HQII were higher for 11 subjects and lower for two. Eight anaesthetists thought HQII asked questions which they omitted while five thought HQII overlooked items. Thirteen anaesthetists believed HQII would be a useful adjunct to their practice. Only ten anaesthetists requested any tests while HealthQuiz II suggested tests for 23 subjects, with an average of 1.9 tests/subject (anaesthetists) vs 5.4 tests/subject (HQII). The total cost of tests selected by anaesthetists was $272.15 in contrast with $1,513.20 for those suggested by HQII. We conclude that rationale for test selection may have contributed to the difference in number and costs of tests.
Résumé
Le HealthQuiz II constitue un dispositif de recueil des données anamneutiques utilisable avant l’anesthésie et la chirurgie. Le HealthQuiz II fournit un résumé des symptômes, une classification ASA modifiée et propose des épreuves de laboratoire. L’objectif de cette étude était de comparer l’évaluation préopératoire et la sélection des épreuves de laboratoires chez un groupe d’anesthésistes qui utilisait soit les méthodes traditionnelles, soit le HealthQuiz II. Vingt- sept anesthésistes de trois hôpitaux universitaires de l’ouest du Canada participaient à l’étude. Ils étaient des hommes âgés de 30 à 50 ans, formés au Canada et exerçant à Calgary, Edmonton et Vancouver. On leur demandait de s’évaluer, de choisir les épreuves de laboratoires et de compléter par la suite le protocole HealthQuiz II, le jour qui précédait une intervention fictive. Les résultats de cette comparaison ont montré que les cotes ASA assignées par HealthQuiz II étaient plus élevées pour onze sujets et plus basses pour deux. Huit anesthésistes ont cru que HealthQuiz II posait des questions qu’ils avaient négligées alors que cinq étaient d’avis que HealthQuiz II négligeait certains questions. Treize anesthésistes ont émis l’opinion que le HealthQuiz II pourrait être utile à leur pratique. Seulement deux anesthésistes ont demandé des épreuves de laboratoire alors que Health-Quiz II suggérait des épreuves pour 23 sujets, avec une moyenne de 1,9 épreuves/sujets (anesthésiste) vs 5,4 épreuves/sujet (HealthQuiz II). Le coût total des épreuves choisies par les anesthésistes était de 272,15$ comparativement à 1513,20$ pour ceux que suggérait le HealthQuiz II. Nous croyons que la raison de la sélection des épreuves peut avoir contribué à la différence entre le nombre et le coût des épreuves.
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Davies, J.M., Pagenkopf, D., Todd, K. et al. Comparison of selection of preoperative laboratory tests: the computer vs the anaesthetist. Can J Anaesth 41, 1156–1160 (1994). https://doi.org/10.1007/BF03020653
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DOI: https://doi.org/10.1007/BF03020653