Prioritisation of elective surgery in New Zealand: The Reliability Study.
OBJECTIVE
This paper describes the rationale and methodology of a study assessing the reliability of tools for clinical prioritisation (Clinical Priority Assessment Criteria [CPAC]) of patients for elective surgery in New Zealand.


METHODS
Surgeons from three specialties (general, vascular, and orthopaedic surgery) completed a computerised evaluation rating clinical vignettes across a range of diagnoses using several priority tools. The study design is described and an outline of the individual tool development and definitions is given.


RESULTS
Of the 124 surgeons that participated in this study, 48% (60) were general surgeons, 21% (26) were vascular surgeons and 31% (38) were orthopaedic surgeons. The response rates in the first phase of data collection were 67%, 79%, and 63% for general, vascular, and orthopaedic surgery respectively. Completion rates were high with 100%, 93%, and 98% of the same groupings of surgeons completing the first round evaluations. A further 77% to 89% of the participants from the first round also completed the re-test evaluation.


CONCLUSIONS
This study indicates that assessment of the reliability of CPAC tools currently in use in New Zealand is feasible using a vignette-based approach. In the future, study designs that allow for some face-to-face contact may be preferable for achieving optimal response and completion rates among surgeons. Further work from this study will focus on the individual results for each specialty and examining whether altering ethnicity status in vignettes had any effect on scoring behaviour.
Doughty
Carolyn
C
Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand. carolyn.doughty@chmeds.ac.nz
MacCormick
Andrew
A
Roake
Justin
J
Fraser
John
J
Hider
Phil
P
Kirk
Ray
R
Parry
Bryan
B
van Rij
Andre
A
Theis
Jean-Claude
JC
D000203:Activities of Daily Living; D017281:Cost of Illness; D003658:Decision Making, Computer-Assisted; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D015276:Health Care Rationing / Q000379:methods*; D006801:Humans; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000601:surgery; D009520:New Zealand; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D010147:Pain Measurement; D014652:Vascular Diseases / Q000175:diagnosis / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data