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The Checklist

Updated: Apr 5, 2023

In his book, The Checklist Manifesto: How to Get Things Right (2009), Atul Gawande makes a compelling argument that we can do better, using the simplest of methods: the checklist. Adapted from other professions, including aviation, it helped socialize the concept of reviewing key attributes for a successful surgery, during the time-out, prior to initiating surgery.

Beyond the Checklist

Many complications are beyond the surgeon time-out with some estimates as high as 32% complication rate with inpatient cases. In the era of AI and EHR, can we do better without asking surgeons to scour patient medical records to assess risk factors?


One of the first entrants is a University of Florida designed artificial-intelligence system called MySurgeryRisk, designed to help surgeons predict patients who are at higher risk for complications after surgery and need more attention or care during and after surgery.

Surgeons using this platform get risk profiles of their patients each day before they begin procedures. Delivered via mobile device, the profiles display the risks of postoperative complications, and how the patient compares to others with similar cases in the cohort.

In a study to describe the prospective validation of the MySurgery Risk platform, surgeons made their own initial predictions, then compared them to the AI predictions. Compared with their initial risk assessment, the accuracy of the surgeons’ repeated risk assessment improved after interacting with the algorithm.

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