Health Technology/clinical-trials

Pre-Post Trial Launches: Can a Clinical Decision Support Tool Reduce Unnecessary Cardiac Testing Before Urgent Surgery? — What Clinicians Need to Know

247 Health News Editorial

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30 July 2026

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4 min read

·clinical-trials

The PERLHS trial at Johns Hopkins is testing whether an Epic-integrated clinical decision support tool can standardise perioperative cardiovascular evaluation for urgent surgical patients, reducing unnecessary cardiac testing and consultation without delaying time to theatre. Enrolling 3,000 patients across two academic medical centres, this pre-post observational study addresses a critical gap in urgent surgical care. Australian perioperative clinicians should watch this space closely.

Originally reported by ClinicalTrials.gov

References

  1. 1.Johns Hopkins University. (2025). PERLHS: How institutional guidelines for urgent inpatient surgeries affect intensity of perioperative cardiovascular testing: A PrePost study (NCT07692503). ClinicalTrials.gov. https://clinicaltrials.gov/study/NCT07692503
  2. 2.Devereaux, P. J., & Sessler, D. I. (2015). Cardiac complications in patients undergoing major noncardiac surgery. New England Journal of Medicine, 373(23), 2258–2269. https://doi.org/10.1056/NEJMra1502824
  3. 3.Fleisher, L. A., Fleischmann, K. E., Auerbach, A. D., Barnason, S. A., Beckman, J. A., Bozkurt, B., Davila-Roman, V. G., Gerhard-Herman, M. D., Holly, T. A., Kane, G. C., Marine, J. E., Nelson, M. T., Spencer, C. C., Thompson, A., Ting, H. H., Uretsky, B. F., & Wijeysundera, D. N. (2014). 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery. Journal of the American College of Cardiology, 64(22), e77–e137. https://doi.org/10.1016/j.jacc.2014.07.944
  4. 4.Kaw, R., Nagarajan, V., Burra, K., Halkar, M., Gali, B., Ponamgi, S., Bhatt, D. L., & Hernandez, A. V. (2021). Postoperative atrial fibrillation, stroke, and mortality after noncardiac surgery. Journal of the American Heart Association, 10(4), e018239. https://doi.org/10.1161/JAHA.120.018239
  5. 5.Smilowitz, N. R., Gupta, N., Guo, Y., Berger, J. S., & Bangalore, S. (2017). Perioperative major adverse cardiovascular and cerebrovascular events associated with noncardiac surgery. JAMA Cardiology, 2(2), 181–187. https://doi.org/10.1001/jamacardio.2017.1798
  6. 6.Wijeysundera, D. N., Austin, P. C., Beattie, W. S., Hux, J. E., & Laupacis, A. (2010). Outcomes and processes of care related to preoperative medical consultation. Archives of Internal Medicine, 170(15), 1365–1374. https://doi.org/10.1001/archinternmed.2010.204
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247 Health News Editorial

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