Importance of Perioperative Glycemic Control in General Surgery: A Report From the Surgical Care and Outcomes Assessment Program
Open accessAbstract
OBJECTIVE: To determine the relationship of perioperative hyperglycemia and insulin administration on outcomes in elective colon/rectal and bariatric operations. BACKGROUND: There is limited evidence to characterize the impact of perioperative hyperglycemia and insulin on adverse outcomes in patients, with and without diabetes, undergoing general surgical procedures. METHODS: The Surgical Care and Outcomes Assessment Program is a Washington State quality improvement benchmarking-based initiative. We evaluated the relationship of perioperative hyperglycemia (>180 mg/dL) and insulin administration on mortality, reoperative interventions, and infections for patients undergoing elective colorectal and bariatric surgery at 47 participating hospitals between fourth quarter of 2005 and fourth quarter of 2010. RESULTS: Of the 11,633 patients (55.4 ± 15.3 years; 65.7% women) with a serum glucose determination on the day of surgery, postoperative day 1, or postoperative day 2, 29.1% of patients were hyperglycemic. After controlling for clinical factors, those with hyperglycemia had a significantly increased risk of infection [odds ratio (OR) 2.0; 95% confidence interval (CI), 1.63-2.44], reoperative interventions (OR, 1.8; 95% CI, 1.41-2.3), and death (OR, 2.71; 95% CI, 1.72-4.28). Increased risk of poor outcomes was observed both for patients with and without diabetes. Those with hyperglycemia on the day of surgery who received insulin had no significant increase in infections (OR, 1.01; 95% CI, 0.72-1.42), reoperative interventions (OR, 1.29; 95% CI, 0.89-1.89), or deaths (OR, 1.21; 95% CI, 0.61-2.42). A dose-effect relationship was found between the effectiveness of insulin-related glucose control (worst 180-250 mg/dL, best <130 mg/dL) and adverse outcomes. CONCLUSIONS: Perioperative hyperglycemia was associated with adverse outcomes in general surgery patients with and without diabetes. However, patients with hyperglycemia who received insulin were at no greater risk than those with normal blood glucoses. Perioperative glucose evaluation and insulin administration in patients with hyperglycemia are important quality targets.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The glycemic threshold for an increase in complications is estimated to be somewhere between 100 and 180 mg/dL in most studies.
“The glycemic threshold for an increase in complications is estimated to be somewhere between 100 and 180 mg/dL (5.5 and 10 mmol/L) in most of these studies (135-138).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [138]
The Methods (Data Specification; page not available) define hyperglycemia as glucose above 180 mg/dL, and the Results associate it with increased complications. The paper does not estimate a 100–180 mg/dL threshold or say that this range applies in most studies. (LLM, conf=0.83)
Experimental — accuracy not yet measuredPeople who develop stress hyperglycaemia have more adverse peri-operative outcomes than those with diabetes mellitus.
“People who develop stress hyperglycaemia have more adverse peri‐operative outcomes than those with diabetes mellitus [78, 79, 80].”
Postoperative hyperglycemia is a well-established risk factor for postoperative complications.
“Postoperative hyperglycemia is a wellestablished risk factor for postoperative complications.157”
From Guidelines for antenatal and preoperative care in cesarean delivery: Enhanced Recovery After Surgery Society recommendations (part 1)—2025 update (2026) · cites this paper as [157]
CGM, particularly when paired with insulin pumps and HCL systems, can lower hypoglycemia occurrence.
“Also, CGM, especially when connected to insulin pumps and HCL devices, can reduce occurrence of hypoglycemia.1248”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1248]
The Methods (Data Specification) say the study recorded only the highest glucose level at each time point and had no information on hypoglycemia. The Discussion likewise says hypoglycemia data were unavailable for this analysis. Searches for CGM, insulin pumps, and hybrid closed-loop systems found no passage addressing whether they reduce hypoglycemia. (LLM, conf=0.75)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
DEYO, R. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90133-8 · Cited by 10,452 · see citing works
Intensive insulin therapy in critically ill patients.
Van den Berghe, G., Wouters, P., Weekers, F., Verwaest, C., Bruyninckx, F., Schetz, M., Vlasselaers, D., Ferdinande, P., Lauwers, P., & Bouillon, R. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa011300 · Cited by 9,977 · see citing works
Intensive versus Conventional Glucose Control in Critically Ill Patients
(2009) · New England Journal of Medicine · doi:10.1056/nejmoa0810625 · Cited by 5,119 · see citing works
Standards of medical care in diabetes 2010
American Diabetes Association (2010) · Diabetes Care · doi:10.2337/dc10-s011 · Cited by 3,470 · see citing works
Basevi, V., Mario, S. D., Morciano, C., Nonino, F., & Magrini, N. (2011) · Diabetes Care · doi:10.2337/dc11-0174 · Cited by 3,058 · see citing works
Intensive insulin therapy and pentastarch resuscitation in severe sepsis
Brunkhorst, F. M., Engel, C., Bloos, F., Meier-Hellmann, A., Ragaller, M., Weiler, N., Moerer, O., Gruendling, M., Oppert, M., Grond, S., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa070716 · Cited by 2,921 · see citing works
Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes
Umpierrez, G. E., Isaacs, S. D., Bazargan, N., You, X., Thaler, L. M., & Kitabchi, A. E. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.3.8341 · Cited by 2,195 · see citing works
den Berghe, G. V., Wouters, P. J., Bouillon, R., Weekers, F., Verwaest, C., Schetz, M., Vlasselaers, D., Ferdinande, P., & Lauwers, P. (2003) · Critical Care Medicine · doi:10.1097/01.ccm.0000045568.12881.10 · Cited by 1,453 · see citing works
Ceriello, A., Esposito, K., Piconi, L., Ihnat, M. A., Thorpe, J. E., Testa, R., Boemi, M., & Giugliano, D. (2008) · Diabetes · doi:10.2337/db08-0063 · Cited by 1,310 · see citing works
Furnary, A. P., Zerr, K. J., Grunkemeier, G. L., & STARR, A. M. (1999) · The Annals of Thoracic Surgery · doi:10.1016/s0003-4975(99)00014-4 · Cited by 1,225 · see citing works
Furnary, A. P., Gao, G., Grunkemeier, G. L., Wu, Y., Zerr, K. J., Bookin, S. O., Floten, H. S., & Starr, A. (2003) · The Journal of Thoracic and Cardiovascular Surgery · doi:10.1067/mtc.2003.181 · Cited by 1,130 · see citing works
Griesdale, D. E. G., de Souza, R. J., van Dam, R. M., Heyland, D. K., Cook, D. J., Malhotra, A., Dhaliwal, R., Henderson, W. R., Chittock, D. R., Finfer, S., et al. (2009) · Canadian Medical Association Journal · doi:10.1503/cmaj.090206 · Cited by 1,096 · see citing works
Glucose Control and Mortality in Critically Ill Patients
Finney, S. J. (2003) · JAMA · doi:10.1001/jama.290.15.2041 · Cited by 1,037 · see citing works
Glucose Control Lowers the Risk of Wound Infection in Diabetics After Open Heart Operations
Zerr, K. J., Furnary, A. P., Grunkemeier, G. L., Bookin, S. O., Kanhere, V. M., & STARR, A. M. (1997) · The Annals of Thoracic Surgery · doi:10.1016/s0003-4975(96)01044-2 · Cited by 908 · see citing works
Quantifying the Risk of Infectious Diseases for People With Diabetes
Shah, B. R., & Hux, J. E. (2003) · Diabetes Care · doi:10.2337/diacare.26.2.510 · Cited by 904 · see citing works
Risk Factors for Surgical Site Infection Following Orthopaedic Spinal Operations
Olsen, M. A. A., Nepple, J. J., Riew, K. D., Lenke, L. G., Bridwell, K. H., Mayfield, J. L., & Fraser, V. J. (2008) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.f.01515 · Cited by 804 · see citing works
Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncardiac surgery
Frisch, A., Chandra, P., Smiley, D., Peng, L., Rizzo, M., Gatcliffe, C., Hudson, M., Mendoza, J., Johnson, R., Lin, E., et al. (2010) · Diabetes Care · doi:10.2337/dc10-0304 · Cited by 739 · see citing works
Umpierrez, G. E., Smiley, D., Jacobs, S., Peng, L., Temponi, A., Mulligan, P., Umpierrez, D., Newton, C., Olson, D., & Rizzo, M. (2011) · Diabetes Care · doi:10.2337/dc10-1407 · Cited by 720 · see citing works
Early postoperative glucose control predicts nosocomial infection rate in diabetic patients.
Pomposelli, J., Baxter, J., Babineau, T., Pomfret, E., Driscoll, D. F., Forse, R., & Bistrian, B. (1998) · JPEN - Journal of Parenteral and Enteral Nutrition · doi:10.1177/014860719802200277 · Cited by 707 · see citing works
Plasma interleukin-6, tumour necrosis factor α and blood cytokine production in type 2 diabetes
Pickup, J. C., Chusney, G. D., Thomas, S. M., & Burt, D. (2000) · Life Sciences · doi:10.1016/s0024-3205(00)00622-6 · Cited by 566 · see citing works
Latham, R. H., Lancaster, A. D., Covington, J. F., Pirolo, J. S., & Thomas, C. S. (2001) · Infection Control and Hospital Epidemiology · doi:10.1086/501830 · Cited by 550 · see citing works
Intraoperative Hyperglycemia and Perioperative Outcomes in Cardiac Surgery Patients
Gandhi, G. Y., Nuttall, G. A., Abel, M., Mullany, C. J., Schaff, H. V., Williams, B. A., Schrader, L. M., Rizza, R. A., & McMahon, M. M. (2005) · Mayo Clinic Proceedings · doi:10.4065/80.7.862 · Cited by 500 · see citing works
Acute hyperglycemia and the innate immune system: Clinical, cellular, and molecular aspects
Turina, M., Fry, D. E., & Polk, H. C. (2005) · Critical Care Medicine · doi:10.1097/01.ccm.0000170106.61978.d8 · Cited by 491 · see citing works
Risk factors for surgical site infection in spinal surgery
Olsen, M. A. A., Mayfield, J. L., Lauryssen, C. L., Polish, L. B., Jones, M., Vest, J. R., & Fraser, V. J. (2003) · Journal of Neurosurgery Spine · doi:10.3171/spi.2003.98.2.0149 · Cited by 468 · see citing works
Relationship of Early Hyperglycemia to Mortality in Trauma Patients
Laird, A. M., Miller, P. R., Kilgo, P. D., Meredith, J. W., & Chang, M. (2004) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/01.ta.0000123267.39011.9f · Cited by 455 · see citing works
Persistent Hyperglycemia is Predictive of Outcome in Critically Ill Trauma Patients
Bochicchio, G. V., Sung, J., Joshi, M. G., Bochicchio, K. M., Johnson, S. B., Meyer, W. A., & Scalea, T. M. (2005) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/01.ta.0000162141.26392.07 · Cited by 436 · see citing works
Carson, J. L., Scholz, P. M., Chen, A. Y., Peterson, E. D., Gold, J. P., & Schneider, S. H. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)01969-1 · Cited by 411 · see citing works
Management of Hyperglycemia in the Hospital Setting
Inzucchi, S. E. (2006) · New England Journal of Medicine · doi:10.1056/nejmcp060094 · Cited by 391 · see citing works
Ramos, M., Khalpey, Z., Lipsitz, S., Steinberg, J., Panizales, M. T., Zinner, M., & Rogers, S. O. (2008) · Annals of Surgery · doi:10.1097/sla.0b013e31818990d1 · Cited by 380 · see citing works
Postoperative hyperglycemia and surgical site infection in general surgery patients
Ata, A. (2010) · Archives of Surgery · doi:10.1001/archsurg.2010.179 · Cited by 379 · see citing works
Hospitals collaborate to decrease surgical site infections
Dellinger, E. P., Hausmann, S. M., Bratzler, D. W., Johnson, R. M., Daniel, D. M., Bunt, K. M., Baumgardner, G. A., & Sugarman, J. R. (2005) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2004.12.001 · Cited by 310 · see citing works
Unrecognized Diabetes Among Hospitalized Patients
Levetan, C. S., Passaro, M., Jablonski, K., Kass, M. E., & Ratner, R. E. (1998) · Diabetes Care · doi:10.2337/diacare.21.2.246 · Cited by 303 · see citing works
Diabetes and Coronary Artery Bypass Surgery
McAlister, F. A., Man, J., Bistritz, L., Amad, H., & Tandon, P. (2003) · Diabetes Care · doi:10.2337/diacare.26.5.1518 · Cited by 271 · see citing works
Schmeltz, L. R., DeSantis, A. J., Thiyagarajan, V., Schmidt, K., O’Shea-Mahler, E., Johnson, D., Henske, J. A., McCarthy, P. M., Gleason, T. G., McGee, E. C., et al. (2007) · Diabetes Care · doi:10.2337/dc06-2184 · Cited by 219 · see citing works
The anti-inflammatory and potential anti-atherogenic effect of insulin: a new paradigm
Dandona, P., Aljada, A., & Mohanty, P. (2002) · Diabetologia · doi:10.1007/s00125-001-0766-5 · Cited by 218 · see citing works
Postoperative Mortality in Cancer Patients With Preexisting Diabetes
Barone, B. B., Yeh, H., Snyder, C. F., Peairs, K. S., Stein, K. B., Derr, R. L., Wolff, A. C., & Brancati, F. L. (2010) · Diabetes Care · doi:10.2337/dc09-1721 · Cited by 183 · see citing works
Vriesendorp, T. M., Morélis, Q. J., DeVries, J. H., Legemate, D. A., & Hoekstra, J. B. L. (2004) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2004.08.006 · Cited by 150 · see citing works
Park, C., Hsu, C.-H., Neelakanta, G., et al. (2009) · Transplantation · doi:10.1097/tp.0b013e31819cc3e6 · Cited by 146 · see citing works
McGirt, M. J., Woodworth, G. F., Brooke, B. S., et al. (2006) · Neurosurgery · doi:10.1227/01.neu.0000215887.59922.36 · Cited by 138 · see citing works
Perioperative Glucose Control in the Diabetic or Nondiabetic Patient
Smiley, D. D., & Umpierrez, G. E. (2006) · Southern Medical Journal · doi:10.1097/01.smj.0000209366.91803.99 · Cited by 127 · see citing works
Ambiru, S., Kato, A., Kimura, F., et al. (2008) · Journal of Hospital Infection · doi:10.1016/j.jhin.2007.12.002 · Cited by 115 · see citing works
McConnell, Y. J., Johnson, P. M., & Porter, G. A. (2008) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-008-0734-1 · Cited by 111 · see citing works
Booth, G., Stalker, T. J., Lefer, A. M., et al. (2001) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.2001.280.6.e848 · Cited by 111 · see citing works
Hyperglycemia as a risk factor for surgical site infections in patients undergoing mastectomy
Vilar‐Compte, D., de Iturbe, I. Á., Martin‐Onraët, A., Pérez-Amador, M., Sánchez-Hernández, C., & Volkow, P. (2008) · American Journal of Infection Control · doi:10.1016/j.ajic.2007.06.003 · Cited by 101 · see citing works
Risk factors for wound infection after cholecystectomy.
Chuang, S., Lee, K., Chang, W., et al. (2004) · PubMed · Cited by 99 · see citing works
Flum, D. R., Fisher, N., Thompson, J., Marcus‐Smith, M., Florence, M. G., & Pellegrini, C. A. (2005) · Surgery · doi:10.1016/j.surg.2005.07.026 · Cited by 84 · see citing works
Self-citationMcGirt, M. J., Woodworth, G. F., Ali, M. S. E. S., et al. (2007) · Journal of neurosurgery · doi:10.3171/jns-07/12/1080 · Cited by 75 · see citing works
HOSPITAL MANAGEMENT OF DIABETES
Levetan, C. S., & Magee, M. F. (2000) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/s0889-8529(05)70162-6 · Cited by 72 · see citing works
Evaluation of hospital glycemic control at US Academic Medical Centers
Boord, J. B., Greevy, R. A., Braithwaite, S. S., Arnold, P. C., Selig, P. M., Brake, H., Cuny, J., & Baldwin, D. (2009) · Journal of Hospital Medicine · doi:10.1002/jhm.390 · Cited by 56 · see citing works
Overt diabetes mellitus adversely affects surgical outcomes of noncardiovascular patients
Bower, W., Jin, L. J., Underwood, M. J., Lee, J. F., Lee, K. F., Lam, Y. H., Ng, S. K., Vlantis, A. C., & Lai, P. B. S. (2010) · Surgery · doi:10.1016/j.surg.2009.10.070 · Cited by 33 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Practice Bulletin No. 183: postpartum hemorrhage
(2017) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000002351 · Cited by 1,406 · see citing works
Handelsman, Y., Bloomgarden, Z. T., Grunberger, G., Umpierrez, G., Zimmerman, R. S., Bailey, T. S., Blonde, L., Bray, G. A., Cohen, A. J., Dagogo-Jack, S., et al. (2015) · Endocrine Practice · doi:10.4158/ep15672.glsuppl · Cited by 559 · see citing works
Blonde, L., Umpierrez, G. E., Reddy, S. S., McGill, J. B., Berga, S. L., Bush, M., Chandrasekaran, S., DeFronzo, R. A., Einhorn, D., Galindo, R. J., et al. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.08.002 · Cited by 507 · see citing works
El‐Boghdadly, K., Dhesi, J., Fabb, P., Levy, N., Lobo, D. N., McKechnie, A., Mustafa, O., Newland‐Jones, P., Patel, A., Pournaras, D. J., et al. (2025) · Anaesthesia · doi:10.1111/anae.16541 · Cited by 147 · see citing works
Perioperative management of hyperglycemia and diabetes in cardiac surgery patients
Galindo, R. J., Fayfman, M., & Umpierrez, G. E. (2018) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2017.10.005 · Cited by 95 · see citing works
Stress hyperglycemia in general surgery: Why should we care?
Davis, G., Fayfman, M., Reyes-Umpierrez, D., Hafeez, S., Pasquel, F. J., Vellanki, P., Haw, J. S., Peng, L., Jacobs, S., & Umpierrez, G. E. (2018) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2017.11.010 · Cited by 80 · see citing works
16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s016 · Cited by 80 · see citing works
Wilson, R. D., Monks, D. T., Sharawi, N., Bamber, J., Panelli, D. M., Sauro, K. M., Shah, P. S., Muraca, G. M., Metcalfe, A., Wood, S. L., et al. (2026) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2025.01.014 · Cited by 22 · see citing works
Fayfman, M., Davis, G., Duggan, E. W., Urrutia, M., Chachkhiani, D., Schindler, J., Pasquel, F. J., Galindo, R. J., Vellanki, P., Reyes-Umpierrez, D., et al. (2018) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2018.08.014 · Cited by 15 · see citing works
Inpatient hyperglycemia and transitions of care: A systematic review
Lansang, M. C., Zhou, K., & Korytkowski, M. T. (2021) · Endocrine Practice · doi:10.1016/j.eprac.2021.01.016 · Cited by 9 · see citing works
Shiffermiller, J., Anderson, M., & Thompson, R. (2024) · Journal of Diabetes Science and Technology · doi:10.1177/19322968241232695 · Cited by 8 · see citing works
Self-citation
- Authors
- Kwon, S., Thompson, R., Dellinger, P., Yanez, D., Farrohki, E., & Flum, D.
- Affiliations
- University of Washington (US)
- Harborview Medical Center (US)
- Providence Regional Medical Center Everett (US)
- Corresponding author
- Kwon, Steve
- Dellinger, Patchen
- Flum, David
- Venue
- Annals of Surgery
- Published
- 2013-01
- Volume
- 257
- Issue
- 1
- Pages
- 8-14
- ISSN
- 0003-4932 (ISSN-L)
- PMC
- PMC4208433
- OpenAlex
- W2115757854
- Semantic Scholar
- dbc7c57ccbc1918481ba8fcdd13b54f442500ff7
- Cited by
- 598
- References
- 50
- Citations by year
- 2026: 45 · 2025: 44 · 2024: 37 · 2023: 50 · 2022: 54 · 2021: 51 · 2020: 49 · 2019: 41 · 2018: 42 · 2017: 54 · 2016: 48 · 2015: 29 · 2014: 32 · 2013: 19 · 2012: 2
- FWCI
- 21.05
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Surgery (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Agency for Healthcare Research and Quality (R01HS020025, 1 R01 HS 20025-01)
- National Institute of Diabetes and Digestive and Kidney Diseases (T32DK070555)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- glycemic control, perioperative hyperglycemia, insulin therapy, colorectal surgery, bariatric surgery, postoperative infection, postoperative mortality, reoperation, diabetes mellitus, dose-response relationship, hospital performance comparison, patient safety
- MeSH terms
- Adult, Aged, Colectomy, Drug Administration Schedule, Female, Humans, Hyperglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Outcome and Process Assessment, Health Care, Rectum, Reoperation, Retrospective Studies, General Surgery, Surgical Wound Infection, Washington, Cohort Studies, Logistic Models, Elective Surgical Procedures, Perioperative Care, Bariatric Surgery
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
