Clinical risk assessments
Figure 2 illustrates patient distribution of clinical risk classification according to assessment method providing a visual of the (dis) agreements observed complemented by the CHAID decision tree method analyses summarised in Figures 2-3.
Subjective: There was clear disagreement between the subjective assessments of risk (ICE-Eyeball (Frailty) compared to Notes Review (Fitness) with ~34 % of patients classified not frail considered unfit by notes review (Figure 3 A). Equally, ~88 % of patients considered not frail and ~82 % of patients considered fit by ICE (Figure 3 B) and notes review (Figure 3 C) respectively were classified ASA Grade II-III (mild to severe disease).
Objective: Subjective assessments generally underestimated patient risk compared to objective CPET criteria ( O2-AT <11 mL/kg/min and intermediate-to-high risk). Indeed, ~35 % of patients considered not frail on ICE and ~31 % of patients considered fit by notes review exhibited a O2-AT <11 mL/kg/min (Figure 4 A-B). Of these, ~28 % and ~19 % (not frail and fit patients respectively) were classified as intermediate-to-high risk by CPET criteria (Figure 4 C-D).