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Physician ratings of appropriate indications for six medical and surgical procedures

Author

Listed:
  • Park, R.E.
  • Fink, A.
  • Brook, R.H.
  • Chassin, M.R.
  • Kahn, K.L.
  • Merrick, N.J.
  • Kosecoff, J.
  • Solomon, D.H.

Abstract

We convened three panels of physicians to rate the appropriateness of a large number of indications for performing a total of six medical and surgical procedures. The panels followed a modified Delphi process. Panelists separately assigned initial ratings, then met in Santa Monica, California where they received reports showing their initial ratings and the distribution of the other panelists' ratings. They discussed the indications and revised the indications lists, then individually assigned final ratings. There was generally better agreement on the final ratings than on the initial ratings. Based on reasonable criteria for agreement and disagreement, and excluding one outlying procedure, the panelists agreed on ratings for 42 to 56 per cent of the indications, and disagreed on 11 to 29 per cent.

Suggested Citation

  • Park, R.E. & Fink, A. & Brook, R.H. & Chassin, M.R. & Kahn, K.L. & Merrick, N.J. & Kosecoff, J. & Solomon, D.H., 1986. "Physician ratings of appropriate indications for six medical and surgical procedures," American Journal of Public Health, American Public Health Association, vol. 76(7), pages 766-772.
    • Handle: RePEc:aph:ajpbhl:1986:76:7:766-772_6
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    Cited by:

    1. McDonnell, Joseph & Meijler, Annejet & Kahan, James P. & Bernstein, Steven J. & Rigter, Henk, 1996. "Panellist consistency in the assessment of medical appropriateness," Health Policy, Elsevier, vol. 37(3), pages 139-152, September.
    2. Joanne K. Tobacman & Bridget Zimmerman & Paul Lee & Lee Hilborne & Hansjoerg Kolder & Robert H. Brook, 2003. "Visual Acuity following Cataract Surgeries in Relation to Preoperative Appropriateness Ratings," Medical Decision Making, , vol. 23(2), pages 122-130, March.
    3. Herrin, Jeph & Etchason, Jeff A. & Kahan, James P. & Brook, Robert H. & Ballard, David J., 1997. "Effect of panel composition on physician ratings of appropriateness of abdominal aortic aneurysm surgery: elucidating differences between multispecialty panel results and specialty society recommendat," Health Policy, Elsevier, vol. 42(1), pages 67-81, October.
    4. Joseph Lipscomb & Giovanni Parmigiani & Vic Hasselblad, 1998. "Combining Expert Judgment by Hierarchical Modeling: An Application to Physician Staffing," Management Science, INFORMS, vol. 44(2), pages 149-161, February.

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