Psychometric testing in the evaluation of the postoperative cardiac patient

Abstract

The first and obvious questions to be asked with regard to psychometric testing in the perioperative period is why does it need to be done? The situation can be considered to be analogous to many others that arise in clinical medicine. For example, if a patient presents with respiratory failure, a competent clinician can diagnose the fact that the patient has respiratory failure and can detail the underlying pathology and, almost certainly, give a diagnosis. Tests of lung function, on the other hand, can document the degree of failure of ventilation but will not decide the aetiology or the prognosis of the condition. I feel that the use of psychometric testing in the perioperative period is in a very similar position, and however sophisticated and precise the tests become they will never be as accurate or valuable as pre- and post-operative clinical assessment by interested psychologists and psychiatrists. The approach whereby trained psychiatric workers perform a pre- and post-operative evaluation has been used in the Hamburg study¹. While the results of this study are uniquely valuable, the degree of commitment of trained personnel both in expertise and time makes such a study design impracticable for general use.