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Use of the American Society of Anesthesiologists Physical Status Classification System in Research

2013; Lippincott Williams & Wilkins; Volume: 117; Issue: 3 Linguagem: Inglês

10.1213/ane.0b013e31829ec1bc

1526-7598

Vincent J. Kopp,

Cardiac, Anesthesia and Surgical Outcomes

To the Editor The March 2013 issue of Anesthesia & Analgesia contains articles describing 12 human studies. Of the 12 studies, 8 mention the American Society of Anesthesiologists Physical Status Classification System (ASA PS CS) and 1 annotates the ASA PS CS source used.1 This reference refers to a 1978 publication.2 This raises a question: When the ASA PS CS is used, shouldn't meticulous referencing follow? As outdated3 and mutated forms4 of the "ASA class" remain extant in journals and on the Internet, editors, reviewers, and readers deserve to know which version a study uses for data reporting. Obviously, clinicians make different patient assessments.5,6 Clinical researchers, though, require low interobserver variability to assure data they report are accurate. The research solution is to urge investigators to prospectively apply and cite the ASA PS CS as found on the ASA Web site.7 Alternatively, editors should require citation of any version actually used when data were gathered. If no standard was applied or chance prevailed when ASA PS CS data were gathered, this should be made explicit. Last, research into cognitive factors that influence how decisions about ASA PS CS assignment are made may help clinical investigators better apply this too-often misapplied tool.8A&A can lead in all 3 areas by starting to require accurate citation when the ASA PS CS is reported and analyzed as data. Vincent J. Kopp, MD, FAAP Department of Anesthesiology School of Medicine University of North Carolina at Chapel Hill Chapel Hill, North Carolina [email protected]