Objectives: We tested the logistic feasibility of integrating brief submaximal cardiopulmonary exercise testing (smCPET) in a pre-surgical evaluation (PSE) clinic. Design: Prospective open-label clinical device trial. Setting: Pre-surgical evaluation clinic. Participants: 43 participants who met criteria of i) age > 60 years old, ii) revised cardiac risk index of <2, iii) self-reported metabolic equivalents (METs) of >4.6 (i.e. ability to climb 2 flights of stairs), and iv) presenting for noncardiac surgery. Interventions: Pre-intervention self-reported METs, Duke Activity Status Index (DASI) surveys, smCPET trial, Borg survey of perceived exertion, and post-intervention survey. Measurements: Feasibility endpoints were 1) operational efficiency as measured by length of time of experimental session < 20 minutes, 2) no more than moderate perceived physical exertion as quantified by a modified Borg survey of perceived exertion of <7 in the absence of observed complications, 3) high participant satisfaction with smCPET task execution, represented as a score of >8, and 4) high patient satisfaction with scheduling of smCPET testing, represented as a score of >8. Results: Session time was 16.9 minutes (+/-6.8). Post-test modified Borg survey was 5.35 (+/-1.8), corresponding to moderate perceived exertion. Satisfaction [on a scale of 1 (worst) to 10 (best)] regarding ease of smCPET tasks was 9.6 (+/-0.7) and mean patient satisfaction with smCPET scheduling was 9.5 (+/-1.5). Operational efficiency was achieved after 10-15 experimental sessions. Conclusions: Our findings suggest that smCPET integration in a PSE clinic; 1) is time efficient 2) shows high participant satisfaction with task, and 3) rapidly achieved operational efficiency.

The listed authors would like to disclose the following affiliations or involvements: ZJC receives partial funding from Shape Medical Systems, Inc. (Minnesota, USA) related to the present work. RBS reports owning stock in Johnson and Johnson unrelated to the present work. RBS reports that Yale University has received funding from Merck for a study in which he was involved, unrelated to the present work. PH reported receiving research support grants from Edwards Lifesciences and consulting and/or royalty fees from Baudax Bio, Fire1Foundry, Cardiage LLC, and Edwards Lifesciences. related to the present work. RBS reports owning stock in Johnson and Johnson unrelated to the 319 present work. RBS reports that Yale University has received funding from Merck for a study in 320 which he was involved, unrelated to the present work. PH reported receiving research support 321 grants from Edwards Lifesciences and consulting and/or royalty fees from Baudax Bio, 322 Fire1Foundry, Cardiage LLC, and Edwards Lifesciences.

ClinicalTrials.gov Registry. #NCT05743673

This study was partially supported by Shape Medical Systems, Inc. (Minnesota, USA).

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This is an ongoing prospective open-label clinical device trial approved by the Yale University Institutional Review Board (IRB#2000033885; ClinicalTrials.gov Registry. #NCT05743673. Principal Investigator: Zyad J. Carr, M.D. Date of Registration: 5-12-2023).

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All data produced in the present study are available upon reasonable request to the authors