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Hayman A, Bentrem D, Prystowsky J. Survey of VA surgeon use and knowledge of the VASQIP mortality calculator. Paper presented at: VA Association of Surgeons Annual Meeting; 2011 Apr 11; Irvine, CA.
Introduction In 2009, VASQIP released an online risk calculator that estimates 30-day mortality after specific general and subspecialty procedures of moderate or greater complexity, given various patient characteristics. The aims of this study were to determine how many active VA surgeons had knowledge about and experience with this VASQIP Mortality Calculator (VMC) and what respondent characteristics were associated with its use. Methods We sent an IRB-approved, 16-question survey to AVAS members about their VMC knowledge and use. Responses were de-identified, and chi-square analysis was used to determine characteristics associated with knowledge of the VMC. Results Our response rate was 30% (85/285). The majority of respondents were male (72%), and 96% were attending surgeons. Half were general surgeons, 34% were cardio- or peripheral vascular surgeons, and 14% were other surgical subspecialists. Nearly all respondents discuss the risk of death with their patients, and over half give an enumerated estimate, based on medical literature (89%), personal experience (78%), or online resources (15%), such as the VMC . Just over half of respondents had heard of the VMC, but only 19 (22%) had used it for patient care. Of these, the majority felt it either correctly estimated (37%) or underestimated (37%) mortality. Thirteen (68%) respondents felt the VMC was clinically relevant. VMC knowledge was not associated with surgeon age, geographic location, or full-time status. General surgeons were more likely to have heard of the VMC calculator (p = 0.022) Conclusions Despite wide dissemination of information regarding the VMC, only 22% of VA surgeons surveyed had used it for patient care. Use of electronic decision support for preoperative risk stratification and informed consent appears limited and has yet to achieve widespread clinical implementation.