Evidence mapPaperPMID 39773953Full record

Observational studyJMIR perioperative medicine2025

Implementation of Brief Submaximal Cardiopulmonary Testing in a High-Volume Presurgical Evaluation Clinic: Feasibility Cohort Study.

Zyad James Carr, Daniel Agarkov, Judy Li, Jean Charchaflieh, Andres Brenes-Bastos, Jonah Freund, Jill Zafar, Robert B Schonberger, Paul Heerdt

2 registry-linked trialsAbstract readObservational Study
In one paragraph

Observational study in JMIR perioperative medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05743673 recruitingnot on this map

A Feasibility Study of the SHAPE™ Test of Aerobic Fitness in Older Adults Presenting for Moderate to High-risk Surgery

TypeobservationalSponsorYale UniversityRan2023 to 2026Enrolled371ConditionsPerioperative/Postoperative Complications, Aerobic CapacityArmsShape II
NCT07519733 recruitingnot on this map

Submaximal Cardiopulmonary Exercise Testing in Adults Presenting for Moderate to High-risk Surgery and Perioperative Outcomes

Typeobservational_patient_registrySponsorYale UniversityRan2025 to 2028Enrolled992ConditionsPostoperative Complications (Cardiopulmonary)ArmsRecruited participants receive preoperative rapid submaximal cardiopulmonary exercise testing within the current risk assessment framework of the pre-surgical evaluation clinic
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Zyad James CarrDepartment of Anesthesiology, Yale University, New Haven, CT, United States.ORCID 0000-0002-6970-3340
Daniel Agarkov *Department of Anesthesiology, Yale University, New Haven, CT, United States.ORCID 0009-0005-9542-1354
Judy LiSchool of Medicine, Yale University, New Haven, CT, United States.ORCID 0000-0002-8755-6751
Jean Charchaflieh *Department of Anesthesiology, Yale University, New Haven, CT, United States.ORCID 0000-0003-2257-2985
Andres Brenes-BastosDepartment of Anesthesiology, Yale University, New Haven, CT, United States.ORCID 0000-0002-0576-2659
Jonah Freund *Syracuse University, Syracuse, NY, United States.ORCID 0009-0008-2779-1152
Jill Zafar *Department of Anesthesiology, Yale University, New Haven, CT, United States.ORCID 0000-0001-6972-1947
Robert B Schonberger *Department of Anesthesiology, Yale University, New Haven, CT, United States.ORCID 0000-0002-5180-5189
Paul Heerdt *Department of Anesthesiology, Yale University, New Haven, CT, United States.ORCID 0000-0002-9765-9885

Funding

Yale Clinical and Translational Science AwardUL1TR001863 · YALE UNIVERSITY · 2025 to 2025
$9.9M
NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

backgroundPrecise functional capacity assessment is a critical component for preoperative risk stratification. Brief submaximal cardiopulmonary exercise testing (smCPET) has shown diagnostic utility in various cardiopulmonary conditions.

objectiveThis study aims to determine if smCPET could be implemented in a high-volume presurgical evaluation clinic and, when compared to structured functional capacity surveys, if smCPET could better discriminate low functional capacity (≤4.6 metabolic equivalents [METs]).

methodsAfter institutional approval, 43 participants presenting for noncardiac surgery who met the following inclusion criteria were enrolled: aged 60 years and older, a Revised Cardiac Risk Index of ≤2, and self-reported METs of ≥4.6 (self-endorsed ability to climb 2 flights of stairs). Subjective METs assessments, Duke Activity Status Index (DASI) surveys, and a 6-minute smCPET trial were conducted. The primary end points were (1) operational efficiency, based on the time of the experimental session being ≤20 minutes; (2) modified Borg survey of perceived exertion, with a score of ≤7 indicating no more than moderate exertion; (3) high participant satisfaction with smCPET task execution, represented as a score of ≥8 (out of 10); and (4) high participant satisfaction with smCPET scheduling, represented as a score of ≥8 (out of 10). Student's t test was used to determine the significance of the secondary end points. Correlation between comparable structured surveys and smCPET measurements was assessed using the Pearson correlation coefficient. A Bland-Altman analysis was used to assess agreement between the methods.

resultsThe mean session time was 16.9 (SD 6.8) minutes. The mean posttest modified Borg survey score was 5.35 (SD 1.8). The median patient satisfaction (on a scale of 1=worst to 10=best) was 10 (IQR 10-10) for scheduling and 10 (IQR 9-10) for task execution. Subjective METs were higher when compared to smCPET equivalents (extrapolated peak METs; mean 7.6, SD 2.0 vs mean 6.7, SD 1.8; t

conclusionsImplementation of smCPET in a presurgical evaluation clinic is both patient centered and clinically feasible. Brief smCPET measures, supportive of published reports regarding low sensitivity of provider-driven or structured survey measures for low functional capacity, were lower than those from structured surveys. Future studies will analyze the prediction of perioperative complications and cost-effectiveness.

trial registrationClinicalTrials.gov NCT05743673; https://clinicaltrials.gov/study/NCT05743673.

Indexed as

Exercise TestPreoperative CareAgedCohort StudiesFeasibility StudiesFemaleHumansMaleMiddle Agedanesthesiologyperioperative medicinepreoperative evaluationrisk stratificationsubmaximal cardiopulmonary exercise test

Identifiers

PMID39773953
PMCPMC11888076

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.