Impact of advanced monitoring variables on intraoperative clinical decision-making: an international survey

Alexandre Joosten, Olivier Desebbe, Koichi Suehiro, Mfonobong Essiet, Brenton Alexander, Cameron Ricks, Joseph Rinehart, David Faraoni, Maurizio Cecconi, Philippe Van der Linden, Maxime Cannesson

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


To assess the relationship between the addition of advanced monitoring variables and changes in clinical decision-making. A 15-questions survey was anonymously emailed to international experts and physician members of five anesthesia societies which focused on assessing treatment decisions of clinicians during three realistic clinical scenarios measured at two distinct time points. The first is when typical case information and basic monitoring (T1) were provided, and then once again after the addition of advanced monitoring variables (T2). We hypothesized that the addition of advanced variables would increase the incidence of an optimal therapeutic decision (a priori defined as the answer with the highest percentage of expert agreement) and decrease the variability among the physician’s suggested treatments. The survey was completed by 18 experts and 839 physicians. Overall, adding advanced monitoring did not significantly increase physician response accuracy, with the least substantial changes noted on questions related to volume expansion or vasopressor administration. Moreover, advanced monitoring data did not significantly decrease the high level of initial practice variability in physician suggested treatments (P = 0.13), in contrast to the low variability observed within the expert group (P = 0.039). Additionally, 5–10 years of practice (P < 0.0001) and a cardiovascular subspecialty (P = 0.048) were both physician characteristics associated with a higher rate of optimal therapeutic decisions. The addition of advanced variables was of limited benefit for most physicians, further indicating the need for more in depth education on the clinical value and technical understanding of such variables.

Original languageEnglish (US)
Pages (from-to)205-212
Number of pages8
JournalJournal of Clinical Monitoring and Computing
Issue number1
StatePublished - Feb 1 2017
Externally publishedYes


  • Education
  • Monitoring
  • Resuscitation

ASJC Scopus subject areas

  • Health Informatics
  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine


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