Abstract
Background: Personalized medicine aims to improve outcomes through application of therapy directed by individualized risk profiles. Whether personalized risk assessment is routinely applied in practice is unclear; the impact of personalized preoperative risk prediction and communication on outcomes has not been synthesized. Our objective was to perform a scoping review to examine the extent, range, and nature of studies where personalized risk was evaluated preoperatively and communicated to the patient and/or healthcare professional. Methods: A systematic search was developed, peer-reviewed, and applied to Embase, Medline, CINAHL, and Cochrane databases to identify studies of individuals having or considering surgery, where a process to assess personalized risk was applied and where these estimates were communicated to a patient and/or healthcare professional. All stages of the review were completed in duplicate. We narratively synthesized and described identified themes. Results: We identified 796 studies; 24 underwent full-text review. Seven studies were included; one communicated personalized risk to patients, four to a healthcare professional, and two to both. Cardiac (n = 2) and orthopedic surgery (n = 2) were the most common surgical specialties. Four studies used electronic risk calculators, and three used paper-based tools. Personalized preoperative risk assessment and communication may improve accuracy of information provided to patients, improve consent processes, and influence length of stay. Methodologic weaknesses in study design were common. Conclusions: Personalized preoperative risk assessment and communication may improve patient and system outcomes. This evidence is limited, however, by weaknesses in study design. Appropriately powered, low risk of bias evaluation of personalized risk communication before surgery is needed.
| Translated title of the contribution | Personalized perioperative medicine: a scoping review of personalized assessment and communication of risk before surgery |
|---|---|
| Original language | French |
| Pages (from-to) | 1026-1037 |
| Number of pages | 12 |
| Journal | Canadian Journal of Anaesthesia |
| Volume | 66 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - Sept 15 2019 |
Bibliographical note
Funding Information:We acknowledge the assistance of Ms. Sascha Davis, Learning Services, The Ottawa Hospital, for help with our search strategy and execution. Drs. Boet, Lalu, and McIsaac are supported by The Ottawa Hospital Anaesthesia Alternate Funds Association. Dr. Lalu is supported by the University of Ottawa Scholarship Protected Time Program. Dr. McIsaac is supported by the Canadian Anesthesiologists’ Society Career Scientist Award and the University of Ottawa Junior Clinical Research Chair in Perioperative Health Systems and Outcomes Research. None declared. This submission was handled by Dr. Steven Backman, Associate Editor, Canadian Journal of Anesthesia. Daniel McIsaac , Emma Harris, and David MacDonald contributed to all aspects of this manuscript, including study conception and design; acquisition, analysis, and interpretation of data; and drafting the article. Laura Boland , Manoj Lalu , and Sylvain Boet contributed to the analysis and interpretation of data.
Publisher Copyright:
© 2019, Canadian Anesthesiologists' Society.
ASJC Scopus Subject Areas
- Anesthesiology and Pain Medicine