Effect of panel composition on appropriateness ratings.
Cholecystectomy is performed frequently and for relatively few indications. An all surgical panel agreed on more indications and fewer contra-indications for cholecystectomy than a mixed specialty panel but did not approve indications for patients with higher comorbidity. In mixed panels subspecialists (gastroenterologists) were more conservative than generalists and surgeons. Similar findings have been shown for carotid endarterectomy. Comparing the results of British and Israeli panels showed variations in rating appropriateness that indicate differences in approach between countries. We conclude that the composition of panels will influence the assessment of appropriateness.
Fraser
G M
GM
Department of Gastroenterolgy, Faculty of Health Sciences, Ben Gurion University, Soroka Medical Center, Beer-Sheva, Israel.
Pilpel
D
D
Kosecoff
J
J
Brook
R H
RH
D002763:Cholecystectomy / Q000706:statistics & numerical data*; D000075202:Contraindications; D003431:Cross-Cultural Comparison; D016894:Endarterectomy, Carotid / Q000706:statistics & numerical data*; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006801:Humans; D007557:Israel; D008505:Medical Staff, Hospital / Q000592:standards*; D010348:Patient Care Team / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D006113:United Kingdom