Arch Bronconeumol. 2012;48(7):229–233 www.archbronconeumol.org Original Article The Initial Phase for Validating the European Algorithm for Functional Assessment Prior to Lung Resection: Quantifying Compliance With the Recommendations in Actual Clinical Practice  Nuria María Novoa, a,* Jacinto Ramos, b Marcelo F. Jiménez, a José María González-Ruiz, b Gonzalo Varela a a Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, Spain b Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, Spain article info Article history: Received 19 October 2011 Accepted 18 February 2012 Available online 29 May 2012 Keywords: Clinical guidelines Lung resection Preoperative evaluation Validation abstract Objective: To quantify the degree of compliance with the recommendations of the clinical practice guide- lines published in 2009 by the ERS and the ESTS regarding the preoperative assessment of risk of lung resection in daily clinical practice at a tertiary hospital. Method: A prospective, observational study of real-time data collected from consecutive patients who had been referred for evaluation from September 2009 to December 2010. We recorded the presence or absence of the recommended studies included in the algorithm, their results and, when a test was missing, the reasons why it was not performed. Hospital mortality and cardio-respiratory morbidity rates are also presented. Results: 173 patients were evaluated. In 171 cases, lung resection was performed, with a mortality of 1.2% and a cardio-respiratory morbidity of 11.7%. The failure rate of the first level of the algorithm was 4.6% and for the second level (VO 2max test) it was 26%. The absence of exercise tests was mainly due to hospital structural problems and the patients’ inability to perform it. Out of the patients who performed the exercise testing, 31 reached a VO 2max of 20 ml/kg-min or more and underwent surgery without calculation of FEV 1 ppo and DCLOppo; 35 patients required the calculation to determine their operability and in 2 cases the intervention was not recommended due to functional inoperability of the patient. Conclusions: The validation process found lack of compliance with the proposed algorithm in 18.5% of the cases basically due to the absence of the exercise tests. The rate of adherence to the algorithm recommendations should be improved before performing any other validation studies. © 2011 SEPAR. Published by Elsevier España, S.L. All rights reserved. Primera fase de validación del algoritmo europeo de evaluación funcional previa a la resección pulmonar: cuantificación del cumplimiento de las recomendaciones en la práctica clínica real Palabras clave: Guía de práctica clínica Resección pulmonar Evaluación preoperatoria Validación resumen Objetivo: Cuantificar el grado de cumplimiento de las recomendaciones contenidas en la guía en la práctica clínica publicada en 2009 por la ERS y la ESTS sobre evaluación preoperatoria del riesgo de la resección pulmonar en la actividad asistencial diaria de un hospital terciario. Método: Estudio prospectivo observacional. Registro de datos en tiempo real de los pacientes consecutivos remitidos para evaluación desde septiembre de 2009 a diciembre de 2010. Se ha registrado la presencia o ausencia de los estudios incluidos en el algoritmo, sus resultados y, en caso de ausencia de alguna prueba, por qué no se realizó. Se aportan las tasas de mortalidad hospitalaria y de morbilidad cardiorrespiratoria postoperatoria.  Please cite this article as: Novoa NM, et al. Primera fase de validación del algoritmo europeo de evaluación funcional previa a la resección pulmonar: cuantificación del cumplimiento de las recomendaciones en la práctica clínica real. Arch Bronconeumol. 2012;48:229–33. * Corresponding author. E-mail address: nuria.novoa@usal.es (N.M. Novoa). 1579-2129/$ – see front matter © 2011 SEPAR. Published by Elsevier España, S.L. All rights reserved.