An assessment of the consistency of ASA physical status classification allocation

The American Society of Anesthesiologists' (ASA) Physical Status Classification was tested for consistency of use by anaesthetists. A postal questionnaire was sent to 113 anaesthetists of varying experience working in the Northern Region of England. They were asked to allot ASA grades to 10 hypothetical patients. Ninety-seven (85.8%) responded to two mailings. In no case was there complete agreement on ASA grade, and in only one case were responses restricted to two of the five possible grades. In one case there was a significant difference in answers between anaesthetists with the FRCA (or equivalent) qualification, and those without. So much variation was observed between individual anaesthetist's assessments when describing common clinical problems that the ASA grade alone cannot be considered to satisfactorily describe the physical status of a patient.