Abstract

Purpose: To determine if a more objective ASA-Physical Status (PS) classification system would improve the accuracy and interrater reliability of anesthesia providers in using this tool. Design: Questionnaire-based pretest-posttest study.

Methods: Study participants assigned PS scores to five realistic patient case scenarios before and after the study intervention. Statistical analysis included a repeated measures ANOVA followed by pairwise comparisons between each group, a paired t-test to measure the overall effect of the study intervention, and a Fleiss’ Kappa calculation to measure interrater reliability.

Findings: The average pretest score for all anesthesia providers was 72.50% (SD, 16.650) with an average posttest score of 95.25% (SD, 9.137). The difference between pretest scores and posttest scores as a whole was statistically significant (t = 14.77; df = 79; p =.000). Before the study intervention, there was poor to fair interrater reliability between anesthesia providers (k=.301, p = < 0.001) and after the implementation of the authors updated and revised PS classification tool, there was excellent interrater reliability (k=.911, p = < 0.001).

Conclusions: The increased objectivity of the revised PS classification system improved the overall accuracy and interrater reliability among anesthesia providers.