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Preoperative Diagnostic Testing and Utilization of Basic Statistics

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.
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