372 posters, 1 audios, 13 topics, 29 sessions, 1,035 authors, 449 institutions
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51st Annual Regional Anesthesiology and Acute Pain Medicine Meeting
April 16 - 18, 2026 | Phoenix, Arizona
2315310
AI-assisted comparison of local neuraxial anticoagulation protocols with ASRA 5th-edition guidance: multi-institution evaluation
Poster Presenter
Part of Topic
Safety/QA/QI Projects
Our AI audit identifies gaps and inconsistencies between institutional protocols and ASRA guidelines.
AI-assisted comparison of institutional protocols for regional anesthesia in patients on anticoagulation with ASRA 5th-edition guidance: Multi-institution evaluatio
Presenter:
Alex Peres, MD, MS
Background
Hospitals adapt society guidance into local protocols, but these documents lag and drift, creating variation and cost.
Clinicians lack time to reconcile local text with the latest ASRA recommendations.
We built an AI-enabled audit to flag Aligned / Inconsistent / Missing items at scale.
Methods
96 recommendations × 5 hospitals = 480
Pipeline: extract ASRA + local clauses (LLMs) → retrieval mapping + label (A/I/M) → validate vs anesthesiologist adjudication
Analyses: χ² for alignment vs evidence level (IA/IB/IC/IIC/2C) and newness (legacy vs new).
Key findings & implications
Large cross-site gaps: 59.8% of items were misaligned (37.3% missing; 22.5% inconsistent)
Reliableaudit vs anesthesiologists’ adjudication:~93% accuracy, ~93% precision, ~98% recall.
Where gaps concentrate: Lower alignment for new and lower level of evidence items (new 20% vs legacy 51.5% aligned; IA 72.5% aligned vs. IC 53.8% and IIC 34.2%, χ² p<0.001).
The model identifies not only where institutions lag behind current guidelines, but also local practices not yet formally adopted by society, flagging these as candidates for future guidelines updates.
Alex Peres, MD, MSc1, Sahil Amin, MD2, Tomer Cramer, PhD3, Ido Zamberg, MD, MEHP3
Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, NY, USA1
Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA2
C8 Health Inc, New York, New York, USA3