Elimination of routine testing in patients undergoing cataract surgery allows substantial savings in laboratory costs. A brief report
Open accessAbstract
Purpose To evaluate the possible cost savings when routine preoperative testing is discontinued in ambulatory cataract surgery patients.Methods A policy was introduced at our hospital to stop routine testing in ambulatory cataract patients. Consecutive patients' medical records were analyzed in a four-month period pre- and a four-month period post-discontinuation of routine laboratory tests. Ambulatory cataract surgery is performed under topical (and sometimes retrobulbar block) anesthesia with iv sedation. Co-morbidities, perioperative events, frequency and cost of tests ordered were compared for the two groups. Average costs per patient pre- and post-discontinuation of routine tests, and total possible cost savings were calculated.Results One thousand two hundred and thirty-one patients were studied; 636 had routine laboratory tests and 595 had no routine laboratory tests. The ratios of gender, co-morbidities and perioperative events were similar in the two groups. There was a significant reduction in the number of tests ordered after the new policy was introduced, from 5.8 tests per patient to 0.4 tests per patient. The cost of tests per patient was reduced from Can $39.67 to $4.01.Conclusion In ambulatory cataract surgery, over 90% savings in laboratory costs is possible after elimination of routine tests.
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Reports continue to document unnecessary routine test ordering.
“Yet, reports continue to document unnecessary routine test ordering [2,4,6,10,31-33]”
There has been a large body of work reporting pre-operative testing practices.
“There has been a large body of work reporting pre-operative testing practices [2,4,6,10,31-33].”
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Cites
Practice Advisory for Preanesthesia Evaluation
Apfelbaum, J. L., Connis, R. T., Nickinovich, D. G., Pasternak, L. R., Arens, J. F., Caplan, R. A., Connis, R. T., Fleisher, L. A., Flowerdew, R. M., Gold, B. S., et al. (2012) · Anesthesiology · doi:10.1097/aln.0b013e31823c1067 · Cited by 845 · see citing works
The Value of Routine Preoperative Medical Testing before Cataract Surgery
Schein, O. D., Katz, J., Bass, E. B., Tielsch, J. M., Lubomski, L. H., Feldman, M. A., Petty, B. G., & Steinberg, E. P. (2000) · New England Journal of Medicine · doi:10.1056/nejm200001203420304 · Cited by 526 · see citing works
The Usefulness of Preoperative Laboratory Screening
Kaplan, E. B. (1985) · JAMA · doi:10.1001/jama.1985.03350480084025 · Cited by 498 · see citing works
Practice Advisory for Preanesthesia Evaluation
NA (2002) · Anesthesiology · doi:10.1097/00000542-200202000-00037 · Cited by 349 · see citing works
The Content and Cost of Cataract Surgery
Steinberg, E. P. (1993) · Archives of Ophthalmology · doi:10.1001/archopht.1993.01090080037016 · Cited by 223 · see citing works
Dzankic, S., Pastor, D., González, C., & Leung, J. M. (2001) · Anesthesia & Analgesia · doi:10.1097/00000539-200108000-00013 · Cited by 210 · see citing works
Dzankic, S., Pastor, D., González, C., et al. (2001) · Anesthesia & Analgesia · doi:10.1213/00000539-200108000-00013 · Cited by 155 · see citing works
Outcomes of Patients With No Laboratory Assessment Before Anesthesia and a Surgical Procedure
Narr, B. J., Warner, M. E., Schroeder, D. R., & Warner, M. A. A. (1997) · Mayo Clinic Proceedings · doi:10.4065/72.6.505 · Cited by 119 · see citing works
Efficacy of preadmission testing in ambulatory surgical patients
Golub, R. W., Cantu, R., Sorrento, J. J., & Stein, H. D. (1992) · The American Journal of Surgery · doi:10.1016/0002-9610(92)90557-8 · Cited by 46 · see citing works
The pre-operative assessment and investigation of ophthalmic patients
McKibbin, M. (1996) · Eye · doi:10.1038/eye.1996.25 · Cited by 27 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Gimbel HV, Hamilton RC. The value of medical test- ing before cataract surgery. Ophthalmic Practice 2000; 18: 166-70.
Cited by
Sorted by citations
the Canada PRIME Plus Team, Patey, A. M., Islam, R., Francis, J. J., Bryson, G. L., & Grimshaw, J. M. (2012) · Implementation Science · doi:10.1186/1748-5908-7-52 · Cited by 237 · see citing works
Elimination of Preoperative Testing in Ambulatory Surgery
Chung, F., Yuan, H., Yin, L., Vairavanathan, S., & Wong, D. T. (2009) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e318176bc19 · Cited by 223 · see citing works
Self-citationCzoski‐Murray, C., Jones, M. L., McCabe, C. J., Claxton, K., Oluboyede, Y., Roberts, J., Nicholl, J., Rees, A., Reilly, C., Young, D., et al. (2012) · Health Technology Assessment · doi:10.3310/hta16500 · Cited by 161 · see citing works
Routine preoperative medical testing for cataract surgery
Keay, L. J., Lindsley, K. B., Tielsch, J. M., Katz, J., & Schein, O. D. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007293.pub3 · Cited by 120 · see citing works
Perioperative Care for the Older Outpatient Undergoing Ambulatory Surgery
White, P. F., White, L. M., Monk, T. G., Jakobsson, J., Raeder, J. C., Mulroy, M. F., Bertini, L., Torri, G., Solca, M., Pittoni, G. M., et al. (2012) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e31824f19b8 · Cited by 107 · see citing works
Finegan, B. A., Rashiq, S., McAlister, F. A., & O’Connor, P. (2005) · Canadian Journal of Anesthesia/Journal canadien d'anesthésie · doi:10.1007/bf03015765 · Cited by 76 · see citing works
Routine preoperative medical testing for cataract surgery
Keay, L. J., Lindsley, K. B., Tielsch, J. M., Katz, J., & Schein, O. D. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007293.pub4 · Cited by 68 · see citing works
Anesthesia for the elderly outpatient
Aurini, L., & White, P. F. (2014) · Current Opinion in Anaesthesiology · doi:10.1097/aco.0000000000000135 · Cited by 47 · see citing works
Ambulatory (Outpatient) Anesthesia
White, P. F., & Eng, M. R. (2010) · Elsevier eBooks · doi:10.1016/b978-0-443-06959-8.00078-9 · Cited by 42 · see citing works
Impact of Preoperative Testing on Ophthalmologic and Systemic Outcomes in Cataract Surgery
Cavallini, G. M., Saccarola, P., D’Amico, R., Gasparin, A., & Campi, L. (2004) · European Journal of Ophthalmology · doi:10.1177/112067210401400502 · Cited by 41 · see citing works
Routine preoperative medical testing for cataract surgery
Keay, L. J., Lindsley, K. B., Tielsch, J. M., Katz, J., & Schein, O. D. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007293.pub2 · Cited by 41 · see citing works
Fischer, S. P., Bader, A. M., & Sweitzer, B. (2010) · Elsevier eBooks · doi:10.1016/b978-0-443-06959-8.00034-0 · Cited by 38 · see citing works
Escort accompanying discharge after ambulatory surgery: a necessity or a luxury?
Ip, H. Y. V., & Chung, F. F. (2009) · Current Opinion in Anaesthesiology · doi:10.1097/aco.0b013e328331d498 · Cited by 36 · see citing works
Self-citationLee, H.-P., Chang, Y., Jean, Y., & Wang, H.-C. (2009) · Injury · doi:10.1016/j.injury.2009.01.008 · Cited by 30 · see citing works
Jastrzebski, A., Villafranca, A., Sethi, S., & Bellan, L. (2016) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-016-0626-x · Cited by 23 · see citing works
Nileshwar, A., Guttikonda, N., Rao, M., & Sushma, T. K. (2019) · Journal of Anaesthesiology Clinical Pharmacology · doi:10.4103/joacp.joacp_342_17 · Cited by 21 · see citing works
Preoperative Medical Testing and Falls in Medicare Beneficiaries Awaiting Cataract Surgery
Chen, C. L., McLeod, S. D., Lietman, T. M., Shen, H., Boscardin, W. J., Chang, H.-Y. P., Whooley, M. A., Gelb, A. W., Lee, S. J., & Dudley, R. A. (2020) · Ophthalmology · doi:10.1016/j.ophtha.2020.09.013 · Cited by 21 · see citing works
Pre‐operative testing guidelines: a NICE try but not enough
Dhatariya, K., & Wiles, M. D. (2016) · Anaesthesia · doi:10.1111/anae.13669 · Cited by 18 · see citing works
Benoit, A. G., Bellan, L., Wallace, M., Toth, G., Djukic, R., Ginter-Boyce, B., Girling, L. G., Dekeyster, C., & Mutter, T. C. (2019) · Canadian Journal of Ophthalmology · doi:10.1016/j.jcjo.2018.12.001 · Cited by 13 · see citing works
García, M. A., Durántez, F. D., Guzmán, C. C., Torres, M. C. P., Parra, R. M.-G., & Jiménez, P. E. (2014) · Revista Española de Anestesiología y Reanimación · doi:10.1016/j.redar.2014.03.016 · Cited by 11 · see citing works
Lawson, J. W., & Kitchens, C. S. (2015) · Current Opinion in Hematology · doi:10.1097/moh.0000000000000172 · Cited by 11 · see citing works
García, M. A., Durántez, F. D., Guzmán, C. C., Torres, M. C. P., Parra, R. M.-G., & Jiménez, P. E. (2015) · Revista Española de Anestesiología y Reanimación (English Edition) · doi:10.1016/j.redare.2014.03.004 · Cited by 9 · see citing works
Kitchens, C. S. (2007) · Elsevier eBooks · doi:10.1016/b978-141602401-9.10037-9 · Cited by 9 · see citing works
Preoperative medical testing for cataract surgery
Keay, L. J., Lindsley, K. B., Tielsch, J. M., Katz, J., Ssemanda, E. N., & Schein, O. D. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007293 · Cited by 5 · see citing works
Irizarry-Alvarado, J. M., Beltran, M., Motoa, G., Carpenter, E. K., Sanchez-Valenzuela, M. C., Garcia‐Saucedo, J. C., Castano, Y. G., & Malavet, P. (2021) · The American Journal of Medicine · doi:10.1016/j.amjmed.2021.07.034 · Cited by 4 · see citing works
Preoperative evaluations for ophthalmic surgery: A systematic review of 48,869 eyes
Hanna, V., Popovic, M. M., El-Defrawy, S. R., Schlenker, M. B., Alaei, R., & Kertes, P. J. (2022) · Survey of Ophthalmology · doi:10.1016/j.survophthal.2022.12.004 · Cited by 4 · see citing works
Patel, R., Shah, S. H., Vedula, S., Omiunu, A. O., Patel, P. S., Eloy, J. A., Baredes, S., & Fang, C. H. (2022) · American Journal of Rhinology and Allergy · doi:10.1177/19458924221136648 · Cited by 3 · see citing works
Lawson, J. W., & Kitchens, C. S. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-46202-0.00034-0 · Cited by 3 · see citing works
Soto-Ruiz, M. N., Silvestre, C., Andonegui-Navarro, J., Eza-Cambra, P., & Calvo-Sáez, J. I. (2006) · Revista de Calidad Asistencial · doi:10.1016/s1134-282x(06)70769-2 · Cited by 2 · see citing works
Küçük ve orta cerrahi girişimlerde preoperatif rutin laboratuar testleri gerekli midir
Toker, A., Girgin, N. K., Türker, G., & Kutlay, O. (2008) · Bursa Uludag University - AVESIS · Cited by 2 · see citing works
Bisinotto, F. M. B., Mesquita, G. B., Miziara, A. N., Martins, L. B., Barcellos, G. O., & da Silveira, L. A. M. (2016) · Revista Brasileira de Oftalmologia · doi:10.5935/0034-7280.20160056 · Cited by 1 · see citing works
Li, J., Hu, H., Li, Z., & Lu, Y. (2025) · Perioperative Medicine · doi:10.1186/s13741-025-00630-9 · Cited by 1 · see citing works
Kitchens, C. S., & Lawson, J. W. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4557-2296-9.00036-1 · Cited by 1 · see citing works
A Simple Screening Tool Reduces Unnecessary Preoperative Evaluation for Cataract Surgery
Hickey, T. R., Kempton, J., & Federman, D. G. (2024) · Quality Management in Health Care · doi:10.1097/qmh.0000000000000491 · Cited by 1 · see citing works
Ambulatory surgery center profitability, efficiency, and cost containment
Archer, T., Mannis, S., & Macario, A. (2008) · Springer eBooks · doi:10.1007/978-0-387-73329-6_15
The Effect of Consultations on the Cost of Pre-Anesthetic Assessment
Erhan, Ö. L., Beştaş, A., Öner, S. F., Yucel, T., Özcan, S., & Arık, H. (2013) · International Journal of Clinical Medicine · doi:10.4236/ijcm.2013.411087
Pre-oping wisely: a guide to more judicious pre-operative testing
Burton, M. (2015)
Eğe, B., & Najafov, E. (2019) · Adıyaman Üniversitesi Sağlık Bilimleri Dergisi · doi:10.30569/adiyamansaglik.609703
Eğe, B., Geyik, A., Kurt, M. Y., & Koparal, M. (2020) · Çukurova medical journal (Online)/Çukurova medical journal · doi:10.17826/cumj.672618
Pantola, P., Rao, B. V., Nair, N., Pavan, D. V., & Dhawan, M. (2026) · Medical Journal Armed Forces India · doi:10.1016/j.mjafi.2026.02.019
Pascual-Prieto, J., Burgos‐Blasco, B., Nieto-Gómez, C., Alvarez-Gallego, S., & García-Feijoo, J. (2026) · European Journal of Ophthalmology · doi:10.1177/11206721261501708
- Authors
- Imasogie, N., Wong, D. T., Luk, K., & Chung, F.
- Affiliations
- University Health Network (CA)
- Corresponding author
- Wong, David T.
- Venue
- Canadian Journal of Anesthesia/Journal canadien d'anesthésie
- Published
- 2003-03
- Volume
- 50
- Issue
- 3
- Pages
- 246-248
- ISSN
- 0832-610X (ISSN-L)
- 1496-8975
- OpenAlex
- W2004723031
- Cited by
- 41
- References
- 9
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 5 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 2 · 2012: 4
- FWCI
- 2.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Canadian Journal of Anesthesia/Journal canadien d anesthésie (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Health Sciences › Health Professions › Emergency Medical Services › Healthcare Operations and Scheduling Optimization
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- cataract surgery, preoperative blood tests, cost reduction, outpatient surgery, laboratory costs, comorbidities, topical anesthesia, retrobulbar block
- MeSH terms
- Ambulatory Surgical Procedures, Cataract Extraction, Diagnostic Tests, Routine, Humans, Cost Savings
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