Preoperative Diagnostic Testing And Utilization Of Basic Statistics

Eric I. Rosenberg, MD, MSPH, FACP

If you are a Program Director and would like to grant access to your trainees, please reach out to education@hospitalmedicine.org for an academic access code.

Summary

Preoperative testing can provide valuable information to identify patients who are at high risk for perioperative complications and reduce perioperative morbidity and mortality; however, there is little benefit from routinely testing patients who are known to be at low risk. The objectives of preoperative testing are to identify patients who are at high risk for perioperative complications, assess the severity or stability of existing medical problems, and evaluate abnormal symptoms or signs detected during the preoperative assessment. This module discusses the common challenges and pitfalls of preoperative testing, describes how pretest probability influences the decision to order preoperative tests, and identifies appropriate indications for laboratory, radiologic, and other forms of preoperative test screening. The selection of appropriate screening tools to identify patients at high risk for specific perioperative complications and the use of post-test probability to select and interpret preoperative diagnostic testing is also examined.

Goal

To provide hospitalists with up-to-date information about preoperative diagnostic testing.

Target Audience

This activity is designed for hospitalists. No prerequisites required.

Learning Objectives

After completing the module, the participant will demonstrate the ability to:

  1. Discuss common challenges and pitfalls of preoperative testing
  2. Describe how pretest probability influences the decision to order preoperative tests
  3. Use post-test probability to select and interpret preoperative diagnostic testing
  4. Examine the influence of posttest probability on test selection
  5. Identify appropriate indications for laboratory, radiologic, and other forms of pre-operative testing
  6. Select appropriate screening tools to identify patients at high risk for specific perioperative complications
Accreditation Statement

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Statement Designation

The Society of Hospital Medicine designates this activity for a maximum of 2.00 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release Date: October ##, 2020

Expiration Date: October ##, 2023

Estimated time to complete: 2 hours

Conflict of Interest Disclosure Policy
In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Off Label Product Discussion

All faculty have indicated that they have not referenced unlabeled or unapproved uses of drugs or devices.

Instructions
The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections: a pre-test, a study program, a post-test, & CME evaluation. All sections must be completed to receive CME credit.
Course summary
Available credit: 
  • 2.00 ABIM MOC Self Evaluation Points
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit
  • 2.00 AMA PRA Category 1 Credit™
Course opens: 
10/08/2020
Course expires: 
10/08/2023
Member cost:
$0.00
Your cost:
$95.00
Rating: 
0
Faculty & Disclosures
Author

Eric I. Rosenberg, MD, MSPH, FACP
Professor and Chief
Division of General Internal Medicine
Department of Medicine
University of Florida College of Medicine
Associate Chief Medical Officer
UF Health Shands Hospitals
Gainesville, Florida

Dr. Rosenberg reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

Editors

Leonard Feldman, MD, FACP, SFHM
Associate Professor of Medicine and Pediatrics
Johns Hopkins University School of Medicine
Urban Health Residency and Track Director
Associate Program Director, Osler Medical Residency
Founding Editor-in-Chief, Consultative & Perioperative Medicine Essentials for Hospitalists
Deputy Editor, Journal of Hospital Medicine
Baltimore, Maryland

Dr. Feldman reports having no significant financial or advisory relationships with corporate organizations related to this activity.

Kurt Pfeifer, MD, FACP, SFHM
Professor of Medicine
General Internal Medicine
Medical Director, Froedtert and Medical College of Wisconsin Eye Institute of Perioperative Services
Medical College of Wisconsin
Associate Editor-in-Chief, Consultative & Perioperative Medicine Essentials for Hospitalists
Milwaukee, Wisconsin

Dr. Pfeifer reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

Additional planners and faculty have no relevant relationships to disclose.

SHM Conflict of Interest Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Off Label Product Discussion

All faculty have indicated that they have not referenced unlabeled or unapproved uses of drugs or devices.

Accreditation Statement

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Statement Designation

The Society of Hospital Medicine designates this activity for a maximum of 2.00 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Available Credit

  • 2.00 ABIM MOC Self Evaluation Points
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit
  • 2.00 AMA PRA Category 1 Credit™

Price

Member cost:
$0.00
Your cost:
$95.00
Please login or register to take this course.

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections: a pre-test, a study program, a post-test, & CME evaluation. All sections must be completed to receive CME credit.

Click START to begin.

If you are a Program Director and would like to grant access to your trainees, please reach out to education@hospitalmedicine.org for an academic access code.