Herrin J, Ballard DJ; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1994; Abstract No. 087.
Thomas Jefferson Health Policy Institute, Charlottesville, VA.
BACKGROUND: The growing use of expert panels to determine health care practice guidelines warrants investigation into how the composition of panels is associated with summary ratings of appropriateness. METHODS: We analyze the rating patterns of a multispeciality panel on abdominal aortic aneurysm (AAA) surgery by the Academic Medical Center Consortium and the RAND Corporation as part of their Clinical Appropriateness Initiative. Partitioning the panel into 3 vascular surgeons and 6 non-vascular surgeons, we examine the deviations from the mean for each of 782 rated cases, using the standard RAND scale from 1 (very inappropriate) to 9 (very appropriate). We also compare the ratings patterns of the vascular surgeons on the panel to the recommendations on elective AAA repair promulgated by the Society for Vascular Surgery. RESULTS: Vascular surgeons ratings (overall mean = 5.6) were above the mean 9-member panel ratings (p less than 0.001) for the 782 indications. Similarly, the non-vascular surgeons' ratings (overall mean = 4.3) were below the mean ratings (p less than 0.001). The more aggressive ratings by the RAND panel vascular surgeons corresponded closely with the recommendations of the Society for Vascular Surgery. CONCLUSION: We conclude that the vascular surgeons on the RAND AAA panel were significantly more likely than non-vascular surgeons to rate a given indication appropriate for AAA repair. We also conclude that the presence on the panel of non-vascular surgeons substantially accounts for the difference between recommendations of the multi-specialty RAND panel and those of the Society for Vascular Surgery.
Publication Types:
Keywords:
- Aortic Aneurysm, Abdominal
- Delivery of Health Care
- Health Planning Guidelines
- Health Services Misuse
- Patient Selection
- Physician's Practice Patterns
- Physicians
- Practice Guidelines as Topic
- Research Design
- Societies
- Societies, Medical
- Specialties, Medical
- surgery
- hsrmtgs
Other ID:
UI: 102211713
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