PMID: 8457691Mar 1, 1993Paper

Indications for cholecystectomy: the results of a consensus panel approach

Quality Assurance in Health Care : the Official Journal of the International Society for Quality Assurance in Health Care
G M FraserR H Brook

Abstract

A consensus panel approach was used in Israel to develop a list of clinical indications for which there was agreement that cholecystectomy should be performed. Nine physicians from different disciplines were asked to score a list of 266 clinical indications for cholecystectomy. Each indication was scored on a scale of 1 (inappropriate, i.e. health risks exceed health benefits) to 9 (appropriate, i.e. benefits exceed risks). Each indication also included one of four comorbidity levels (none to high). Agreement and disagreement were defined and panelists met to discuss, modify and rescore the list. The composition of the panel and definitions of agreement had a considerable impact on the preparation of a list of agreed, appropriate indications for cholecystectomy. Gastroenterologists in the panel were less likely to recommend surgery than either surgeons or general internists both before and after the panel discussion. Following the discussion the level of agreement (defined as after discarding the highest and lowest score all of the remaining seven panelists were in a 3-point range) increased from 39% to 46% (p < 0.08) and disagreement decreased from 27% to 18% (p < 0.01). Fifty-nine of the 266 indications were considered approp...Continue Reading

Citations

Dec 4, 2009·Journal of Neuro-oncology·Mark E Linskey, Steven N Kalkanis
Dec 7, 2002·Quality & Safety in Health Care·J M QuintanaA Bilbao
Dec 31, 1993·Annals of the New York Academy of Sciences·R H Brook
Dec 17, 2009·Acta Veterinaria Scandinavica·Johanna C PenellAgneta Egenvall
May 1, 1996·Journal of Evaluation in Clinical Practice·A MilesA Polychronis
Jan 6, 2000·Journal of Health Services Research & Policy·N BlackT Marteau
Oct 4, 1997·Health Services Management Research : an Official Journal of the Association of University Programs in Health Administration·R C BradburyP M Steen
Mar 27, 2004·ANZ Journal of Surgery·Michael S HobbsMathew W Knuiman
Dec 29, 2004·Annals of Surgery·José Ma QuintanaAmaia Bilbao

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