Prioritisation of patients on waiting lists for hip and knee arthroplasties and cataract surgery: Instruments validation.
BACKGROUND
Prioritisation instruments were developed for patients on waiting list for hip and knee arthroplasties (AI) and cataract surgery (CI). The aim of the study was to assess their convergent and discriminant validity and inter-observer reliability.


METHODS
Multicentre validation study which included orthopaedic surgeons and ophthalmologists from 10 hospitals. Participating doctors were asked to include all eligible patients placed in the waiting list for the procedures under study during the medical visit. Doctors assessed patients' priority through a visual analogue scale (VAS) and administered the prioritisation instrument. Information on socio-demographic data and health-related quality of life (HRQOL) (HUI3, EQ-5D, WOMAC and VF-14) was obtained through a telephone interview with patients. The correlation coefficients between the prioritisation instrument score and VAS and HRQOL were calculated. For the reliability study a self-administered questionnaire, which included hypothetic patients' scenarios, was sent via postal mail to the doctors. The priority of these scenarios was assessed through the prioritisation instrument. The intraclass correlation coefficient (ICC) between doctors was calculated.


RESULTS
Correlations with VAS were strong for the AI (0.64, CI95%: 0.59-0.68) and for the CI (0.65, CI95%: 0.62-0.69), and moderate between the WOMAC and the AI (0.39, CI95%: 0.33-0.45) and the VF-14 and the CI (0.38, IC95%: 0.33-0.43). The results of the discriminant analysis were in general as expected. Inter-observer reliability was 0.79 (CI95%: 0.64-0.94) for the AI, and 0.79 (CI95%: 0.63-0.95) for the CI.


CONCLUSIONS
The results show acceptable validity and reliability of the prioritisation instruments in establishing priority for surgery.
Allepuz
Alejandro
A
Quality in Health Care Area, Catalan Agency for Health Technology Assessment and Research, Carrer de Roc Boronat, 81-95 (segona planta) 08005, Barcelona, Spain. aallepuz@aatrm.catsalut.net
Espallargues
Mireia
M
Moharra
Montse
M
Comas
Mercè
M
Pons
Joan M V
JM
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002387:Cataract Extraction; D005260:Female; D015276:Health Care Rationing / Q000379:methods; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology; D009985:Orthopedics; D018579:Patient Selection; D017064:Process Assessment, Health Care / Q000145:classification* / Q000592:standards; D011788:Quality of Life; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D013030:Spain; D014850:Waiting Lists