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Fam Pract Manag. 2014;21(1):27

Author disclosure: no relevant financial affiliations disclosed.

The Pre-Op Eval app provides evidence-based guidelines for the preoperative evaluation of patients undergoing noncardiac surgery and perioperative medication management.

Source: Wilson Family Medicine Residency and Binghamton University, New York

Platforms available: iOS only

Pertinence to primary care practice: Preoperative consultations are the “bread and butter” of most primary care practices. This app guides clinicians through the American College of Cardiology's stepwise algorithm for the cardiac evaluation, which takes into account surgery risk level and urgency, presence or absence of active cardiac conditions, functional capacity, and other clinical risk factors. It also provides helpful resources on the use of common perioperative medications; the timing of noncardiac surgery after a myocardial infarction or revascularization; and indications for preoperative electrocardiography, chest radiography, and blood tests.

Authoritativeness/accuracy/currency of information: The app content is based on current relevant guidelines from the American College of Cardiology (ACC)/American Heart Association (AHA), the Institute for Clinical Systems Improvement, and the American College of Chest Physicians. Areas of disagreement between guidelines are highlighted, when applicable. The developer plans to update the app when these guidelines are revised.

Cost: Free to all users

Ease of use: I found it easy to navigate from the main menu through the interactive algorithm and the associated resources. Text is concise and easily readable, an impressive achievement given the complexity and length of the original sources. For example, the 81-page ACC/AHA guideline for the perioperative cardiac evaluation is distilled into a series of submenus that require a maximum of six clicks to yield unambiguous results.

Sponsors: No outside funding was used to develop this app.


This excellent free app is a must-have for any family physician with an iOS-compatible device.


  • S – Source or developer of app

  • P – Platforms available

  • P – Pertinence to primary care practice

  • A – Authoritativeness/accuracy/currency of information

  • C – Cost

  • E – Ease of use

  • S – Sponsor(s)

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