title: Prioritisation of elective surgery in New Zealand: The Reliability Study.
abstract: 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.
authors.affiliation: 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
authors.forename: Carolyn
authors.initials: C
authors.lastname: Doughty
authors.forename: Andrew
authors.initials: A
authors.lastname: MacCormick
authors.forename: Justin
authors.initials: J
authors.lastname: Roake
authors.forename: John
authors.initials: J
authors.lastname: Fraser
authors.forename: Phil
authors.initials: P
authors.lastname: Hider
authors.forename: Ray
authors.initials: R
authors.lastname: Kirk
authors.forename: Bryan
authors.initials: B
authors.lastname: Parry
authors.forename: Andre
authors.initials: A
authors.lastname: van Rij
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Theis
mesh_terms: 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