National Institute for Health and Clinical Excellence guidelines on preoperative tests: the use of routine preoperative tests for elective surgery

Ann Clin Biochem 2006;43:13-16
doi:10.1258/000456306775141623
© 2006 Association for Clinical Biochemistry

 

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TM Reynolds


Clinical Chemistry Department, Queen’s Hospital, Belvedere Road, Burton-on-Trent, Staffordshire DE13 0RB, UK; Division of Sciences, Wolverhampton University, Wolverhampton, UK

Clinical Guideline CG3 from the National Institute for Health and Clinical Excellence (NICE) makes recommendations on appropriate clinical practice in preoperative testing for elective surgery. Unfortunately, there is minimal evidence on which the guidelines could be based and therefore they were constructed on the basis of professional opinion. This resulted in the construction of a decision matrix of Byzantine complexity built on foundations of sand: surgical risk is estimated using an unvalidated ad hoc risk estimation method; anaesthetic risk is estimated usingthe American Society of Anesthesiologists (ASA) risk methodthat has been demonstrated to be incapable of generating consistentrisk assessments. The resultant matrix may be suitable for useas a template for future research, but is extremely complexand inadequately rigorous for routine use.

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