Franklin Dexter

In this issue of the British Journal of Anaesthesia, Jiao and colleagues applied a neural network model for surgical case durations to predict the operating room times remaining for ongoing anaesthetics. We review estimation of case durations before each case starts, showing why their scientific focus is useful. We also describe managerial epidemiology studies of historical data by the scheduled procedure or distinct combinations of scheduled procedures included in each surgical case. Most cases have few or no historical data for the scheduled procedures. Generalizability of observational results such as theirs, and automatic computer assisted clinical and managerial decision-making, are both facilitated by using structured vocabularies when analysing surgical procedures.

Parmar and colleagues developed and validated a graphical method for choosing the number of operating theatres to set aside for urgent surgical cases. We address appropriate usage of their new method for calculating anaesthesia staffing, including comparison with previously published techniques. Parmar and colleagues' method is based on all staff scheduled in-house, rather than some on-call from home. We review that this is not nearly as large a limitation as it may seem because of behavioural factors of staff assignment.