title: Determination of the anaerobic threshold in the pre-operative assessment clinic: inter-observer measurement error.
abstract: The variability between observers in the interpretation of cardiopulmonary exercise tests may impact upon clinical decision making and affect the risk stratification and peri-operative management of a patient. The purpose of this study was to quantify the inter-reader variability in the determination of the anaerobic threshold (V-slope method). A series of 21 cardiopulmonary exercise tests from patients attending a surgical pre-operative assessment clinic were read independently by nine experienced clinicians regularly involved in clinical decision making. The grand mean for the anaerobic threshold was 10.5 ml O(2).kg body mass(-1).min(-1). The technical error of measurement was 8.1% (circa 0.9 ml.kg(-1).min(-1); 90% confidence interval, 7.4-8.9%). The mean absolute difference between readers was 4.5% with a typical random error of 6.5% (6.0-7.2%). We conclude that the inter-observer variability for experienced clinicians determining the anaerobic threshold from cardiopulmonary exercise tests is acceptable.
authors.affiliation: Department of Anaesthesia, The James Cook University Hospital, University of Teesside, Middlesbrough, UK. Rhona.Sinclair@ncl.ac.uk
authors.forename: R C F
authors.initials: RC
authors.lastname: Sinclair
authors.forename: G R
authors.initials: GR
authors.lastname: Danjoux
authors.forename: V
authors.initials: V
authors.lastname: Goodridge
authors.forename: A M
authors.initials: AM
authors.lastname: Batterham
mesh_terms: D015308:Anaerobic Threshold; D002983:Clinical Competence; D005080:Exercise Test / Q000379:methods; D006801:Humans; D015588:Observer Variation; D011300:Preoperative Care / Q000379:methods*