Utility and Reliability of a Pediatric Preanesthesia Questionnaire: A Monocentric Prospective Study in a Tunisian Public Hospital

<ns3:p>Background The conventional preanesthetic evaluation process can be resource-intensive and time-consuming. Preanesthetic questionnaires have been proposed to alleviate the burden on clinical resources. This study aimed to assess the reliability and predictive accuracy of a pediatric preanesthetic screening questionnaire as a potential alternative to the standard preanesthetic consultation. Methods An evaluative, prospective, cross-sectional, single-center study was conducted from October 2022 to May 2023 in the Outpatient Clinic of the Department of Anesthesiology, Habib Thameur Hospital, Tunis. A 43-item bilingual (French/Arabic) paper-based questionnaire was completed for 300 pediatric patients (aged 1 month to 18 years) scheduled for elective surgery. Responses were compared with standard preanesthetic evaluations by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen’s kappa coefficient (κ) for agreement. Results All 300 patients completed the questionnaire (completion rate = 100%). Most were classified as ASA Physical Status I (78.3%). Agreement between questionnaire responses and physician assessments was excellent for 34 of 43 items (κ > 0.8; p < 0.001), with perfect agreement (κ = 1.000; p < 0.001) for item 10. Near-perfect agreement was observed for ASA classification (κ = 0.953; p < 0.001; concordance rate = 98.3%). Eight items had κ values between 0.397 and 0.798, and one item (myopathy) could not be analyzed due to uniformly negative responses. Conclusion The pediatric preanesthesia questionnaire demonstrated high reliability and strong agreement with physician assessments. It may serve as an effective triage tool to optimize outpatient workflows and reduce clinical workload, particularly for low-risk pediatric patients.</ns3:p>