Consistency across panels of ratings of appropriateness of dental care treatment procedures.
OBJECTIVE
To report on a study investigating the consistency across different consensus panels of ratings of appropriateness for dental procedures.


METHODS
The study conducted four consensus panels to determine, under various conditions, the appropriateness of five options for patients: no treatment; filling; crown; root canal with a filling or crown; extraction. The patients were categorised according to age; regular versus irregular use of dental care; degree of caries; degree of pain; degree of periodontal disease.


METHODS
The panellists were dentists enrolled in a continuing education programme on assessing the quality of dental care. The panellists were all individuals employed by various dental plans to evaluate the quality of care plans operating in California.


RESULTS
The results indicate that the method does distinguish the dimensions of appropriateness used by the panellists in making their decisions, and that it is possible to substantially increase consensus among a diverse group of dentists and across separate panels on some procedures. However, it also showed that the process is sensitive to varying panels and that different variables had different outcomes in the ratings from the various panels.


CONCLUSIONS
The consensus panel method holds some promise for determining the appropriateness of dental care. However the results of this study question whether it results in consistent ratings across different panels.
Coulter
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ID
School of Dentistry, University of California, Los Angeles 90095-1668, USA.
Marcus
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Freed
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JR
D000328:Adult; D002140:California; D003245:Consensus Statements as Topic; D003442:Crowns / Q000706:statistics & numerical data; D003657:Decision Making; D003729:Dental Care / Q000592:standards*; D003731:Dental Caries / Q000628:therapy*; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D012390:Root Canal Therapy / Q000706:statistics & numerical data; D014081:Tooth Extraction / Q000706:statistics & numerical data; D014600:Utilization Review