Development of appropriateness explicit criteria for cataract extraction by phacoemulsification

BMC Health Services Research
José M QuintanaInmaculada Aróstegui

Abstract

Consensus development techniques were used in the late 1980s to create explicit criteria for the appropriateness of cataract extraction. We developed a new appropriateness of indications tool for cataract following the RAND method. We tested the validity of our panel results. Criteria were developed using a modified Delphi panel judgment process. A panel of 12 ophthalmologists was assembled. Ratings were analyzed regarding the level of agreement among panelists. We studied the influence of all variables on the final panel score using linear and logistic regression models. The explicit criteria developed were summarized by classification and regression tree analysis. Of the 765 indications evaluated by the main panel in the second round, 32.9% were found appropriate, 30.1% uncertain, and 37% inappropriate. Agreement was found in 53% of the indications and disagreement in 0.9%. Seven variables were considered to create the indications and divided into three groups: simple cataract, with diabetic retinopathy, or with other ocular pathologies. The preoperative visual acuity in the cataractous eye and visual function were the variables that best explained the panel scoring. The panel results were synthesized and presented in three d...Continue Reading

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Citations

Sep 29, 2009·Journal of Hepato-biliary-pancreatic Surgery·J M Molina-LindeP Parra-Membrives
Jan 26, 2008·International Journal of Technology Assessment in Health Care·Elena AndradasFrancisco-Javier Gracia
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Software Mentioned

SAS
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RAND
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