Objectives: To collect and summarize information published byINAHTA agencies on the indications, habitual attitudes and practices,and economic and legal implications of preoperative evaluation inelective surgeries.

Method: The authors appraised the informationcontained in six papers published between 1989 and 1999 in Sweden,France, Basque Country, the Netherlands, United Kingdom, andCatalonia. The section on indications in preoperative evaluationdoes not present global conclusions. The sections addressinghabitual attitudes and practices among physicians and thoseaddressing economic and legal considerations cover only thesimilarities among the reports and the main ideas relating to theseissues.

Results: The conclusions found in the reports about indicationsin preoperative evaluation are similar or differ slightly, e.g., asregards age limits in patients for whom the tests are recommended.However, more important differences are shown in other areas,especially in reports where consensus methods were used. In someinstances, the opinions, attitudes, and customary practices ofprofessionals during the preoperative stage do not concur with therecommendations extracted from the assessment reports and thecustomary practice of doctors. In relation to economicconsiderations, a substantial quantity of resources could beliberated if the recommended general clinical practices werefollowed. From the point of view of civil law, the evidence-basedrecommendations could be considered as a kind of coded lex artis.