COMPARISON OF SELECTION OF PREOPERATIVE LABORATORY TESTS - THE COMPUTER VS THE ANESTHETIST

Health quiz II (HQII) is a computerized history-taking device which ca n be used by patients before anaesthesia and surgery. Healt Quiz II pr ovides a summary of symptoms, a modified RSA Classification, and a lis t of suggested laboratory tests. Developed at the University of Chicag o, the device has not been evaluated in Canada. The purpose of this st udy was to compare preoperative evaluation and selection of laboratory tests by a group of Canadian anaesthetists using traditional methods versus using Health Quiz II. Twenty-seven anaesthetists from three (We stern) Canadian University teaching hospitals participated in the stud y. The subjects were male, aged between 30-50 yr, trained in Canada an d practicing in Calgary, Edmonton and Vancouver They were asked to sel f-evaluate and select laboratory tests and then to complete the HQII p rotocol, the day before a proposed mock operation. Results of this com parison showed that the RSA scores assigned by HQII were higher for II subjects and lower for two. Eight anaesthetists thought HQII asked qu estions which they omitted while five thought HQII overlooked items. T hirteen anaesthetists believed Hell would be a useful adjunct to their practice. Only ten anaesthetists requested any tests while Health Qui z II suggested tests for 23 subjects, with an average of 1.9 tests/sub ject (anaesthetists) vs 5.4 tests/subject (HQII). The total cost of te sts selected by anaesthetists was $272.15 in contrast with $1,513.20 f or those suggested by HQII We conclude that rationale for rest selecti on may have contributed to the difference in number and costs of tests .