Home > References - Benefits and Harms of...

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

Balk EM, Earley A, Hadar N, et al. Benefits and Harms of Routine Preoperative Testing: Comparative Effectiveness [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Jan. (Comparative Effectiveness Reviews, No. 130.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.


Apfelbaum JL, Connis RT, Nickinovich DG, et al. Practice advisory for preanesthesia evaluation: an updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2012 Mar;116(3):522–38. [PubMed: 22273990]
Kumar A, Srivastava U. Role of routine laboratory investigations in preoperative evaluation. J Anaesthesiol Clin Pharmacol. 2011 Apr;27(2):174–79. [PMC free article: PMC3127294] [PubMed: 21772675]
Bryson GL. Has preoperative testing become a habit? Can J Anaesth. 2005 Jun;52(6):557–61. [PubMed: 15983138]
Kaplan EB, Sheiner LB, Boeckmann AJ, et al. The usefulness of preoperative laboratory screening. JAMA. 1985 Jun 28;253(24):3576–81. [PubMed: 3999339]
Johnson RK, Mortimer AJ. Routine pre-operative blood testing: is it necessary? Anaesthesia. 2002 Sep;57(9):914–17. [PubMed: 12190758]
Pasternak LR. Preoperative testing: moving from individual testing to risk management. Anesth Analg. 2009 Feb;108(2):393–94. [PubMed: 19151262]
MacPherson RD, Reeve SA, Stewart TV, et al. Effective strategy to guide pathology test ordering in surgical patients. ANZ J Surg. 2005 Mar;75(3):138–43. [PubMed: 15777393]
Klein AA, Arrowsmith JE. Should routine pre-operative testing be abandoned? Anaesthesia. 2010 Oct;65(10):974–76. [PubMed: 21198466]
National Collaborating Centre for Acute Care (UK). Preoperative Tests: The use of routine preoperative tests for elective surgery. London: National Institute for Health and Clinical Excellence; 2003. Guidance. [PubMed: 21089235]
Czoski-Murray C, Lloyd Jones M, McCabe C, et al. What is the value of routinely testing full blood count, electrolytes and urea, and pulmonary function tests before elective surgery in patients with no apparent clinical indication and in subgroups of patients with common comorbidities: a systematic review of the clinical and cost-effective literature. Health Techol Assess. 2012;16(50):1–159. [PMC free article: PMC4781410] [PubMed: 23302507]
Keay L, Lindsley K, Tielsch J, et al. Routine preoperative medical testing for cataract surgery. Cochrane Database of Systematic Reviews. 2012;(3):CD0079293. [PMC free article: PMC4261928] [PubMed: 22419323]
Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. J Am Coll Cardiol. 2007 Oct 23;50(17):1707–32. [PubMed: 17950159]
American College of Radiology. ACR Appropriateness Criteria: Routine Admission and Preoperative Chest Radiography. 2013. http://www​.acr.org/∼​/media/ACR/Documents​/AppCriteria​/Diagnostic/RoutineAdmissionAndPreoperativeChestRadiography​.pdf.
American Society of Anesthesiologists. ASA Physical Status Classification System. http://www​.asahq.org​/Home/For-Members/Clinical-Information​/ASA-Physical-Status-Classification-System. Last accessed 7/1/2013.
Wallace BW, Small K, Brodley CE, et al. Deploying an interactive machine learning system in an evidence-based practice center: Abstrackr. Proceedings of the ACM International Health Informatics Symposium (IHI) 2012:819–24.
Owens DK, Lohr KN, Atkins D, et al. AHRQ series paper 5: grading the strength of a body of evidence when comparing medical interventions--agency for healthcare research and quality and the effective health-care program. J Clin Epidemiol. 2010 May;63(5):513–23. [PubMed: 19595577]
Higgins JP. Cochrane handbook for systematic reviews of interventions. Version 5.0.2. The Cochrane Collaboration; 2009. [updated September 2009]
Chou R, Aronson N, Atkins D, et al. AHRQ series paper 4: assessing harms when comparing medical interventions: AHRQ and the effective health-care program. J Clin Epidemiol. 2010 May;63(5):502–12. [PubMed: 18823754]
Santaguida P, Raina P, Ismaila A. McMaster Quality Assessment Scale of Harms (McHarm) for primary studies. http://bmg​.cochrane.org/sites/bmg​.cochrane​.org/files/uploads​/McHarm%20for%20Primary%20Studies.pdf, last accessed 1/8/13.
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–88. [PubMed: 3802833]
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002 Jun 15;21(11):1539–58. [PubMed: 12111919]
Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ. 2003 Sep 6;327(7414):557–60. [PMC free article: PMC192859] [PubMed: 12958120]
Whitlock EP, Lopez SA, Chang S, et al. AHRQ series paper 3: identifying, selecting, and refining topics for comparative effectiveness systematic reviews: AHRQ and the effective health-care program. J Clin Epidemiol. 2010 May;63(5):491–501. [PubMed: 19540721]
Berkman ND, Lohr KN., Ansari Meal. Grading the Strength of a Body of Evidence When Assessing Health Care Interventions for the Effective Health Care Program of the Agency for Healthcare Research and Quality: An Update. Methods Research Report. 2013 PENDING. [PubMed: 24404627]
Almanaseer Y, Mukherjee D, Kline-Rogers EM, et al. Implementation of the ACC/AHA guidelines for preoperative cardiac risk assessment in a general medicine preoperative clinic: improving efficiency and preserving outcomes. Cardiology. 2005;103(1):24–29. [PubMed: 15528897]
Cavallini GM, Saccarola P, D'Amico R, et al. Impact of preoperative testing on ophthalmologic and systemic outcomes in cataract surgery. Eur J Ophthalmol. 2004 Sep;14(5):369–74. [PubMed: 15506597]
Finegan BA, Rashiq S, McAlister FA, et al. Selective ordering of preoperative investigations by anesthesiologists reduces the number and cost of tests. Can J Anaesth. 2005 Jun;52(6):575–80. [PubMed: 15983141]
Larocque BJ, Maykut RJ. Implementation of guidelines for preoperative laboratory investigations in patients scheduled to undergo elective surgery. Can J Surg. 1994 Oct;37(5):397–401. [PubMed: 7922901]
Leonard JV, Clayton BE, Colley JR. Use of biochemical profile in children's hospital: results of two controlled trials. Br Med J. 1975 Jun 21;2(5972):662–65. [PMC free article: PMC1673573] [PubMed: 1095116]
Lira RP, Nascimento MA, Moreira-Filho DC, et al. Are routine preoperative medical tests needed with cataract surgery? Rev Panam Salud Publica. 2001 Jul;10(1):13–17. [PubMed: 11558245]
Nascimento MA, Lira RP, Soares PH, et al. Are routine preoperative medical tests needed with cataract surgery? Study of visual acuity outcome. Curr Eye Res. 2004 Apr;28(4):285–90. [PubMed: 15259298]
Meneghini L, Zadra N, Zanette G, et al. The usefulness of routine preoperative laboratory tests for one-day surgery in healthy children. Paediatr Anaesth. 1998;8(1):11–15. [PubMed: 9483592]
Schein OD, Katz J, Bass EB, et al. The value of routine preoperative medical testing before cataract surgery. Study of Medical Testing for Cataract Surgery. N Engl J Med. 2000 Jan 20;342(3):168–75. [PubMed: 10639542]
Wyatt WJ, Reed DN Jr., Apelgren KN. Pitfalls in the role of standardized preadmission laboratory screening for ambulatory surgery. Am Surg. 1989 Jun;55(6):343–46. [PubMed: 2729769]
Zwack GC, Derkay CS. The utility of preoperative hemostatic assessment in adenotonsillectomy. Int J Pediatr Otorhinolaryngol. 1997 Feb 14;39(1):67–76. [PubMed: 9051441]
Chung F, Yuan H, Yin L, et al. Elimination of preoperative testing in ambulatory surgery. Anesth Analg. 2009;108(2):467–75. [PubMed: 19151274]
Falcone RA, Nass C, Jermyn R, et al. The value of preoperative pharmacologic stress testing before vascular surgery using ACC/AHA guidelines: a prospective, randomized trial. J Cardiothorac Vasc Anesth. 2003;17(6):694–98. [PubMed: 14689407]
Mancuso CA. Impact of new guidelines on physicians' ordering of preoperative tests. J Gen Intern Med. 1999;14(3):166–72. [PMC free article: PMC1496555] [PubMed: 10203622]
Mignonsin D, Degui S, Kane M, et al. [Value of selective prescription of preanesthetic laboratory tests]. Cah Anesthesiol. 1996;44(1):13–17. [French] [PubMed: 8762245]
Aghajanian A, Grimes DA. Routine prothrombin time determination before elective gynecologic operations. Obstet Gynecol. 1991 Nov;78(5:Pt 1):837–39. [PubMed: 1923209]
Alsumait BM, Alhumood SA, Ivanova T, et al. A prospective evaluation of preoperative screening laboratory tests in general surgery patients. Med Princ Pract. 2002 Jan;11(1):42–45. [PubMed: 12116695]
Azzam FJ, Padda GS, DeBoard JW, et al. Preoperative pregnancy testing in adolescents. Anesth Analg. 1996 Jan;82(1):4–7. [PubMed: 8712424]
Baron MJ, Gunter J, White P. Is the pediatric preoperative hematocrit determination necessary? South Med J. 1992 Dec;85(12):1187–89. [PubMed: 1470961]
Bhuripanyo K, Prasertchuang C, Chamadol N, et al. The impact of routine preoperative chest X-ray in Srinagarind Hospital, Khon Kaen. J Med Assoc Thai. 1990 Jan;73(1):21–28. [PubMed: 2345323]
Bhuripanyo K, Prasertchuang C, Viwathanatepa M, et al. The impact of routine preoperative electrocardiogram in patients age > or = 40 years in Srinagarind Hospital. J Med Assoc Thai. 1992 Jul;75(7):399–406. [PubMed: 1293256]
Bhuripanyo K, Khumsuk K, Sornpanya N, et al. The impact of routine preoperative complete blood count (CBC) in elective operations in Srinagarind Hospital. J Med Assoc Thai. 1995 Jan;78(1):42–47. [PubMed: 7622976]
Bhuripanyo K, Prasertchuang C, Khumsuk K, et al. The impact of routine preoperative urinalysis in Srinagarind Hospital, Khon Kaen. J Med Assoc Thai. 1995 Feb;78(2):94–98. [PubMed: 7629451]
Bouillot JL, Fingerhut A, Paquet JC, et al. Are routine preoperative chest radiographs useful in general surgery? A prospective, multicentre study in 3959 patients. Association des Chirurgiens de l'Assistance Publique pour les Evaluations medicales. Eur J Surg. 1996 Aug;162(8):597–604. [PubMed: 8891616]
Burk CD, Miller L, Handler SD, et al. Preoperative history and coagulation screening in children undergoing tonsillectomy. Pediatrics. 1992 Apr;89(4:Pt 2):691–95. [PubMed: 1557263]
Bushick JB, Eisenberg JM, Kinman J, et al. Pursuit of abnormal coagulation screening tests generates modest hidden preoperative costs. J Gen Intern Med. 1989 Nov;4(6):493–97. [PubMed: 2585157]
Carliner NH, Fisher ML, Plotnick GD, et al. The preoperative electrocardiogram as an indicator of risk in major noncardiac surgery. Can J Cardiol. 1986 May;2(3):134–37. [PubMed: 3719447]
Charpak Y, Blery C, Chastang C, et al. Usefulness of selectively ordered preoperative tests. Med Care. 1988 Feb;26(2):95–104. [PubMed: 3339918]
Charpak Y, Blery C, Chastang C, et al. Prospective assessment of a protocol for selective ordering of preoperative chest x-rays. Can J Anaesth. 1988 May;35(3:(Pt 1)):259–64. [PubMed: 3383317]
Correll DJ, Hepner DL, Chang C, et al. Preoperative electrocardiograms: patient factors predictive of abnormalities. Anesthesiology. 2009 Jun;110(6):1217–22. [PubMed: 19417620]
Gabriel P, Mazoit X, Ecoffey C. Relationship between clinical history, coagulation tests, and perioperative bleeding during tonsillectomies in pediatrics. J Clin Anesth. 2000 Jun;12(4):288–91. [PubMed: 10960200]
Gold BS, Young ML, Kinman JL, et al. The utility of preoperative electrocardiograms in the ambulatory surgical patient. Arch Intern Med. 1992 Feb;152(2):301–05. [PubMed: 1739358]
Golub R, Cantu R, Sorrento JJ, et al. Efficacy of preadmission testing in ambulatory surgical patients. Am J Surg. 1992;163(6):565–70. [PubMed: 1595835]
Haug RH, Reifeis RL. A prospective evaluation of the value of preoperative laboratory testing for office anesthesia and sedation. J Oral Maxillofac Surg. 1999 Feb 21;57(1):16–20. [PubMed: 9915390]
Hoare TJ. Pre-operative haemoglobin estimation in paediatric ENT surgery. J Laryngol Otol. 1993 Dec;107(12):1146–48. [PubMed: 8289005]
Ipp L, Flynn P, Blanco J, et al. The findings of preoperative cardiac screening studies in adolescent idiopathic scoliosis. J Pediatr Orthop. 2011 Oct;31(7):764–66. [PubMed: 21926874]
Johnson H Jr., Knee-Ioli S, Butler TA, et al. Are routine preoperative laboratory screening tests necessary to evaluate ambulatory surgical patients? Surgery. 1988 Oct;104(4):639–45. [PubMed: 3175862]
Kahn RL, Stanton MA, Tong-Ngork S, et al. One-year experience with day-of-surgery pregnancy testing before elective orthopedic procedures. Anesth Analg. 2008;106(4):1127–31. [PubMed: 18349183]
Lafferty JE, North CS, Spitznagel E, et al. Laboratory screening prior to ECT. J ECT. 2001 Sep;17(3):158–65. [PubMed: 11528304]
Lawrence VA, Kroenke K. The unproven utility of preoperative urinalysis. Clinical use. Arch Intern Med. 1988 Jun;148(6):1370–73. [PubMed: 3377621]
Mallick MS. Is routine pre-operative blood testing in children necessary? Saudi Med J. 2006 Dec;27(12):1831–34. [PubMed: 17143358]
Malviya S, D'Errico C, Reynolds P, et al. Should pregnancy testing be routine in adolescent patients prior to surgery? Anesth Analg. 1996 Oct;83(4):854–58. [PubMed: 8831334]
Manning SC, Beste D, McBride T, et al. An assessment of preoperative coagulation screening for tonsillectomy and adenoidectomy. Int J Pediatr Otorhinolaryngol. 1987 Oct;13(3):237–44. [PubMed: 3679679]
Mantha S, Roizen MF, Madduri J, et al. Usefulness of routine preoperative testing: a prospective single-observer study. J Clin Anesth. 2005 Feb;17(1):51–57. [PubMed: 15721730]
Narr BJ, Hansen TR, Warner MA. Preoperative laboratory screening in healthy Mayo patients: cost-effective elimination of tests and unchanged outcomes. Mayo Clin Proc. 1991 Feb;66(2):155–59. [PubMed: 1899710]
Nigam A, Ahmed K, Drake-Lee AB. The value of preoperative estimation of haemoglobin in children undergoing tonsillectomy. Clin Otolaryngol Allied Sci. 1990 Dec;15(6):549–51. [PubMed: 2073764]
O'Connor ME, Drasner K. Preoperative laboratory testing of children undergoing elective surgery. Anesth Analg. 1990 Feb;70(2):176–80. [PubMed: 2301750]
Paterson KR, Caskie JP, Galloway DJ, et al. The pre-operative electrocardiogram: an assessment. Scott Med J. 1983 Apr;28(2):116–18. [PubMed: 6867689]
Perez A, Planell J, Bacardaz C, et al. Value of routine preoperative tests: a multicentre study in four general hospitals. Br J Anaesth. 1995 Mar;74(3):250–56. [PubMed: 7718366]
Pierre N, Moy LK, Redd S, et al. Evaluation of a pregnancy-testing protocol in adolescents undergoing surgery. J Pediatr Adolesc Gynecol. 1998 Aug;11(3):139–41. [PubMed: 9704304]
Roy WL, Lerman J, McIntyre BG. Is preoperative haemoglobin testing justified in children undergoing minor elective surgery? Can J Anaesth. 1991 Sep;38(6):700–03. [PubMed: 1914052]
Sane SM, Worsing RA Jr., Wiens CW, et al. Value of preoperative chest X-ray examinations in children. Pediatrics. 1977 Nov;60(5):669–72. [PubMed: 917629]
Silvestri L, Maffessanti M, Gregori D, et al. Usefulness of routine pre-operative chest radiography for anaesthetic management: a prospective multicentre pilot study. Eur J Anaesthesiol. 1999 Nov;16(11):749–60. [PubMed: 10713868]
Tape TG, Mushlin AI. How useful are routine chest x-rays of preoperative patients at risk for postoperative chest disease? J Gen Intern Med. 1988 Jan;3(1):15–20. [PubMed: 3339483]
Van Damme H, Pierard L, Gillain D, et al. Cardiac risk assessment before vascular surgery: a prospective study comparing clinical evaluation, dobutamine stress echocardiography, and dobutamine Tc-99m sestamibi tomoscintigraphy. Cardiovasc Surg. 1997 Feb;5(1):54–64. [PubMed: 9158124]
Leppo J, Plaja J, Gionet M, et al. Noninvasive evaluation of cardiac risk before elective vascular surgery. J Am Coll Cardiol. 1987 Feb;9(2):269–76. [PubMed: 3805515]
Phillips MB, Bendel RE, Crook JE, et al. Global health implications of preanesthesia medical examination for ophthalmic surgery. Anesthesiology. 2013;118(5):1038–45. [PubMed: 23508220]
Eagle KA, Berger PB, Calkins H, et al. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) J Am Coll Cardiol. 2002 Feb 6;39(3):542–53. [PubMed: 11823097]
Qaseem A, Snow V, Fitterman N, et al. Risk assessment for and strategies to reduce perioperative pulmonary complications for patients undergoing noncardiothoracic surgery: a guideline from the American College of Physicians. Ann Intern Med. 2006 Apr 18;144(8):575–80. [PubMed: 16618955]
Smetana GW, Lawrence VA, Cornell JE, et al. Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians. Ann Intern Med. 2006 Apr 18;144(8):581–95. [PubMed: 16618956]
Schein OD, Katz J, Bass EB, et al. The value of routine preoperative medical testing before cataract surgery. Study of Medical Testing for Cataract Surgery. N Engl J Med. 2000 Jan 20;342(3):168–75. [PubMed: 10639542]
Myers E, Sanders GD, Ravi D, et al. Evaluating the Potential Use of Modeling and Value-of-Information Analysis for Future Research Prioritization Within the Evidence-based Practice Center Program. Rockville, MD: Agency for Healthcare Research and Quality; Jun, 2011. (Prepared by the Duke Evidence-based Practice Center under Contract No. 290-2007-10066-I.) AHRQ Publication No. 11-EHC030-EF. Available at: www​.effectivehealthcare​.ahrq.gov/reports/final.cfm. [PubMed: 21977527]
Cover of Benefits and Harms of Routine Preoperative Testing: Comparative Effectiveness
Benefits and Harms of Routine Preoperative Testing: Comparative Effectiveness [Internet].
Comparative Effectiveness Reviews, No. 130.
Balk EM, Earley A, Hadar N, et al.


AHRQ (US Agency for Healthcare Research and Quality)

PubMed Health Blog...

read all...

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...