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Inter-rater variability for the American Society of Anesthesiologists classification in patients undergoing hepato-pancreato-biliary surgery (MILESTONE-2):international survey among surgeons and anaesthesiologists

Title: Inter-rater variability for the American Society of Anesthesiologists classification in patients undergoing hepato-pancreato-biliary surgery (MILESTONE-2):international survey among surgeons and anaesthesiologists
Authors: Augustinus, Simone; Sijberden, Jasper P.; Bieze, Matthanja; Agarwal, Vandana; Aldrighetti, Luca A.; Alseidi, Adnan; Bonofiglio, Francisco C.; Conlon, Kevin C.P.; Donadello, Katia; Erdmann, Joris; Ferrone, Cristina; Guertin, Michael; Harter, Ronald; Franceschetti, Maria E.; Fusai, Guiseppe K.; Koerkamp, Bas Groot; Hackert, Thilo; Jang, Jin Young; Kander, Thomas; Keck, Tobias; Krzanicki, Dominik; Lee, Ho Jin; Lewis, Keith; Natalini, Giuseppe; Nau, Carla; Pawlik, Timothy M.; Pitt, Henry A.; Reineke, Rafaella; Salvia, Roberto; de Santibanes, Eduardo; Shrikhande, Shailesh V.; Smith, Martin; Szijarto, Attila; Tingstedt, Bobby; Wei, Alice C.; Windsor, John; Hilal, Mohammed Abu; Pardo, Manuel; Hollmann, Markus W.; Besselink, Marc G.
Source: Augustinus, S, Sijberden, J P, Bieze, M, Agarwal, V, Aldrighetti, L A, Alseidi, A, Bonofiglio, F C, Conlon, K C P, Donadello, K, Erdmann, J, Ferrone, C, Guertin, M, Harter, R, Franceschetti, M E, Fusai, G K, Koerkamp, B G, Hackert, T, Jang, J Y, Kander, T, Keck, T, Krzanicki, D, Lee, H J, Lewis, K, Natalini, G, Nau, C, Pawlik, T M, Pitt, H A, Reineke, R, Salvia, R, de Santibanes, E, Shrikhande, S V, Smith, M, Szijarto, A, Tingstedt, B, Wei, A C, Windsor, J, Hilal, M A, Pardo, M, Hollmann, M W & Besselink, M G ....
Publication Year: 2025
Subject Terms: /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being; name=SDG 3 - Good Health and Well-being
Description: Background : Patients undergoing hepato-pancreato-biliary surgery are typically preoperatively assessed using the American Society of Anesthesiologists (ASA) classification, which is also used for case-mix adjustment when comparing centre outcomes. Studies determining the inter-rater variability of the ASA classification within hepato-pancreato-biliary surgery are currently lacking. Methods : An international survey was collected and a case-vignette study was performed (November 2022–April 2023) regarding the ASA classification in patients undergoing hepato-pancreato-biliary surgery among anaesthesiologists and surgeons from (inter)national societies. The survey consisted of 23 questions and eight case-vignettes. Primary analysis included descriptive statistics and the inter-rater variability was calculated using Light’s Kappa. Results : Overall, 1283 participants from 55 countries responded: 1073 (84%) anaesthesiologists and 210 (16%) surgeons. The ASA classification was commonly used, both clinically 1003/1283 (78%) and for research 728/762 (96%). The majority of respondents (n = 1019, 79%) declared that ASA score impacted their perioperative strategy. There inter-rater variability was fair–moderate (Kappa 0.26–0.42) in all case-vignettes. Inter-rater variability differed within and among geographic regions for each case. Over 80% (n = 1138) of respondents stated that they would take the underlying disease (for example cancer) into account, but this changed the preferred ASA score within the case-vignettes by only 1%. Type of surgery changed the preferred score in the case-vignettes (13% difference). The most common suggestions to improve the ASA classification were to clarify whether type of operation should be considered, create a more extensive definition, and provide more examples. Conclusions : Inter-rater variability was present within the ASA classification of patients undergoing hepato-pancreato-biliary surgery, which may impact perioperative strategy and hamper research results. Additional guidance to ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 2474-9842
Relation: info:eu-repo/semantics/altIdentifier/pmid/40036750; info:eu-repo/semantics/altIdentifier/pissn/2474-9842; info:eu-repo/semantics/altIdentifier/eissn/2474-9842
DOI: 10.1093/bjsopen/zrae162
Availability: https://pure.eur.nl/en/publications/92f6b4c9-f887-498a-b0fd-a47345ba59fa; https://doi.org/10.1093/bjsopen/zrae162; https://pure.eur.nl/ws/files/188227457/zrae162.pdf; https://www.scopus.com/pages/publications/86000654490
Rights: info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.3AEA7773
Database: BASE