American Society of Anesthesiologists’ Physical Status system
Bibliographic record
Abstract
CONTEXT: Variability of American Society of Anesthesiologists' (ASA) physical status scores attributed to the same patient by multiple physicians has been reported in several studies. In these studies, the population was limited and diseases that induced disagreement were not analysed. OBJECTIVES: To evaluate the reproducibility of ASA physical status assessment on a large population, as used in current practice before scheduled surgery. DESIGN: Multicentre, randomised, blinded cross-over observational study. METHODS: During a 2-week period in nine institutions, ASA physical status and details of assessment performed routinely by anaesthesiologists for patients who underwent elective surgery were recorded. Records were blinded (including ASA physical status) by an independent statistical division and returned randomly to one of the nine centres for reassessment by accredited specialist anaesthesiologists. MAIN OUTCOME MEASURES: The level of agreement between the two measurements of the ASA physical status was calculated by using the weighted Kappa coefficient. RESULTS: During the study period, 1554 anaesthesia records were collected and 197 were excluded from analysis because of missing data. After the initial evaluation, the distribution of ASA physical status grades was as follows: ASA 1, 571; ASA 2, 591; ASA 3, 177; and ASA 4, 18. After the final evaluation, the distribution of ASA grades was as follows: ASA 1, 583; ASA 2, 520; ASA 3, 223; and ASA 4, 31. Two per cent of the patients had an underestimation of their physical status. The degree of agreement between the two measures evaluated by the weighted Kappa coefficient was 0.53 (0.49-0.56). No difference was observed between public and private institutions. Patients with co-existing diseases, obesity, allergy, sleep apnoea, obstructive lung disease, renal insufficiency and hypertension were least likely to have been graded correctly. CONCLUSION: The degree of agreement between two measures of the ASA physical status grade is moderate and influenced by staff characteristics and the complexity of diseases.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".