title: Impact of varying panel membership on ratings of appropriateness in consensus panels: a comparison of a multi- and single disciplinary panel.
abstract: OBJECTIVE
  The objective of the study was to examine the appropriateness ratings for the use of spinal manipulation for low back pain of a multidisciplinary panel of medical and chiropractic physicians, and those of a panel composed only of chiropractic physicians.
  
  
  METHODS
  The study analyzed data from two consensus panels conducted at RAND in 1990 and 1991.
  
  
  METHODS
  The study design followed that of the traditional RAND consensus panels. Nine individuals comprised each panel, and each panelist was asked to rate, on a nine-point scale, the indications for spinal manipulation twice, the first time alone and the second time jointly with the panel.
  
  
  METHODS
  The ratings of the panelists from both groups, for both round one and round two, were collated and compared.
  
  
  RESULTS
  While both panels were more likely to rate the indications as inappropriate than appropriate, the single disciplinary panel was more likely to rate an indication as appropriate than the multidisciplinary panel.
  
  
  CONCLUSIONS
  The composition of a panel clearly influences the ratings and those who use a given procedure in practice, in this case manipulation, are more likely to rate it as appropriate than those who do not use the procedure.
authors.affiliation: RAND, Santa Monica, CA 90407-2138, USA.
authors.forename: I
authors.initials: I
authors.lastname: Coulter
authors.forename: A
authors.initials: A
authors.lastname: Adams
authors.forename: P
authors.initials: P
authors.lastname: Shekelle
mesh_terms: D002684:Chiropractic; D003245:Consensus Statements as Topic; D003657:Decision Making; D005069:Evaluation Studies as Topic; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D010820:Physicians; D017410:Practice Guidelines as Topic