COMPUTERIZED DATA-COLLECTION IN THE OPERATING-ROOM DURING CORONARY-ARTERY BYPASS-SURGERY - A COMPARISON TO THE HAND-WRITTEN ANESTHESIA RECORD

Objective: To investigate variability between hand-written and compute rized anesthesia records and evaluate any associated bias, Design and Measurements: A computer system that was used to collect intraoperativ e data for a study of hemodynamic management during coronary artery by pass graft surgery is described. The system collected and recorded hem odynamic data automatically downloaded from the anesthesia monitor as well as surgical events and drug administration data entered through m enu options. The system then combined, summarized, and graphed the dat a as well as formatted it for export to a commercially available datab ase program. In a sample of 14 patients, blood pressure data collected by the computer system was compared with the blood pressure data char ted in the hand-written anesthesia record. Main Results: Although gene ral linear models controlling for within-patient variation and randomi zation assignment for mean arterial pressure range on cardiopulmonary bypass showed a significant relationship; low R-2 values indicated tha t much of the variability could not be explained and that there was, t herefore, poor agreement between the two records. Furthermore, a syste matic bias in the hand-written anesthesia record was found when the co mputer system record was compared with the hand-written record and to the difference of the two records, so that extremes seen in the comput er system record tended to be minimized in the hand-written anesthesia record. Conclusion: Because of the lack of explained variability betw een the computer system and hand-written anesthesia records and the bi as in the hand-written anesthesia record, the hand-written anesthesia record should not be relied on as a source of accurate data for resear ch purposes. Copyright (C) 1997 by W.B. Saunders Company.