Article type
Year
Abstract
Introduction/Objective: The aim of the study was to acquire information on current behaviour of a sample of Italian surgeons and anesthesiologists about prescribing, interpreting and using routine preoperative investigations and gain an understanding of knowledge and attitude of attending physicians toward this activity.
Methods: The survey was carried out by means of a questionnaire which included questions about:- how routine preoperative investigation was organized, which routines were included and the frequency of preoperative investigations; - the impact of routine preoperative investigations results on scheduled interventions. In each sampled hospital, all consultants in surgery or anesthesiology who had responsibility in heading surgical wards were interviewed.
Results: 606 surgeons and anesthesiologists were interviewed in 60 hospitals in Northern, Central and Southern Italy. 95% of doctors responded to follow no formal protocol or guidelines in prescribing routine examinations but their own personal knowledge and practical experience. 93.8% of doctors always perform anamnesis and 94.2% always perform physical examination of patients, while the frequency of clinicians always prescribing chest radiography is 81.2%, ECG is 99.3% and laboratory tests is 99.1%.
Discussion: The survey indicates that practice in Italy concerning routine preoperative investigation is quite homogeneous although attitude and knowledge of attending physicians vary significantly in certain respects. The study shows that prescription of these procedures by doctors is driven more by personal experience than updated scientific knowledge. This often leads to ineffective and inefficient clinical practice with healthy patients undergoing useless, time consuming, costly and sometimes, harmful procedures.
Methods: The survey was carried out by means of a questionnaire which included questions about:- how routine preoperative investigation was organized, which routines were included and the frequency of preoperative investigations; - the impact of routine preoperative investigations results on scheduled interventions. In each sampled hospital, all consultants in surgery or anesthesiology who had responsibility in heading surgical wards were interviewed.
Results: 606 surgeons and anesthesiologists were interviewed in 60 hospitals in Northern, Central and Southern Italy. 95% of doctors responded to follow no formal protocol or guidelines in prescribing routine examinations but their own personal knowledge and practical experience. 93.8% of doctors always perform anamnesis and 94.2% always perform physical examination of patients, while the frequency of clinicians always prescribing chest radiography is 81.2%, ECG is 99.3% and laboratory tests is 99.1%.
Discussion: The survey indicates that practice in Italy concerning routine preoperative investigation is quite homogeneous although attitude and knowledge of attending physicians vary significantly in certain respects. The study shows that prescription of these procedures by doctors is driven more by personal experience than updated scientific knowledge. This often leads to ineffective and inefficient clinical practice with healthy patients undergoing useless, time consuming, costly and sometimes, harmful procedures.