title: Validation of pre-operative patient self-assessment of cardiac risk for non-cardiac surgery: foundations for decision support.
abstract: OBJECTIVE
  To better characterize patient understanding of their risk of cardiac complications from non-cardiac surgery and to develop a patient driven clinical decision support system for preoperative patient risk management.
  
  
  METHODS
  A patient-driven preoperative self-assessment decision support tool for perioperative assessment was created. Patient' self-perception of cardiac risk and self-report data for risk factors were compared with gold standard preoperative physician assessment to evaluate agreement.
  
  
  RESULTS
  The patient generated cardiac risk profile was used for risk score generation and had excellent agreement with the expert physician assessment. However, patient subjective self-perception risk of cardiovascular complications had poor agreement with expert assessment.
  
  
  CONCLUSIONS
  A patient driven cardiac risk assessment tool provides a high degree of agreement with expert provider assessment demonstrating clinical feasibility. The limited agreement between provider risk assessment and patient self-perception underscores a need for further work including focused preoperative patient education on cardiac risk.
authors.affiliation: Minneapolis VA Healthcare System, University of Minnesota ; Institute for Health Informatics, University of Minnesota ; College of Pharmacy, University of Minnesota.
authors.forename: Sharad
authors.initials: S
authors.lastname: Manaktala
authors.affiliation: Health Services Research and Policy, School of Public Health, University of Minnesota.
authors.forename: Todd
authors.initials: T
authors.lastname: Rockwood
authors.affiliation: Minneapolis VA Healthcare System, University of Minnesota ; Institute for Health Informatics, University of Minnesota ; College of Pharmacy, University of Minnesota.
authors.forename: Terrence J
authors.initials: TJ
authors.lastname: Adam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D003658:Decision Making, Computer-Assisted; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011183:Postoperative Complications; D057234:Preoperative Period; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012647:Self-Assessment