Dtsch Arztebl Int
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Pulmonary function tests (PFTs) such as spirometry and blood gas analysis have been claimed to improve preoperative risk assessment. This systematic review summarizes the available scientific literature regarding the ability of PFTs to predict postoperative pulmonary complications (PPC) in non-thoracic surgery. ⋯ As the existing literature is inconclusive it is currently unknown if PFTs improve risk assessment before non-thoracic surgery. Spirometry should be considered in individuals with key indicators for chronic obstructive pulmonary disease (COPD) scheduling for upper abdominal surgery.
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The findings of observational studies can be distorted by a number of factors. So-called confounders are well known, but distortion by collider bias (CB) has received little attention in medical research to date. The goal of this article is to present the principle of CB, and measures that can be taken to avoid it, by way of a few illustrative examples. ⋯ CB is a distortion that arises through restriction on or stratification by a collider variable, or through statistical adjustment for a collider variable in a regression model. CB can arise in many ways. The graphic representation of causal structures helps to identify potential sources of CB. It is important to distinguish confounders from colliders, as methods that serve to correct for confounding can themselves cause bias when applied to colliders. There is no generally applicable method for correcting CB.