title: Application of the RAND/UCLA Appropriateness Method to evaluate an information system for kidney/pancreas transplantation in adult recipients.
abstract: With the aim to evaluate the correctness of medical and surgical procedures, RAND Corporation and University of California Los Angeles (UCLA) developed the RAND/UCLA Appropriateness Method (RAM). In this study, the RAM was applied to evaluate the appropriateness of a dataset concerning kidney/pancreas transplantation in adult recipients for an information system funded by the Italian Ministry of Health. The original dataset was obtained using an interdisciplinary pool of experts (n=60) involved in kidney/pancreas transplantation activity in the Liguria Region. This dataset held 291 items, stratified as pretransplantation items (n=158), transplantation items (n=49), and early posttransplantation and follow-up items (n=84). In the second round, the dataset was subjected to an extraregional panel of independent experts (n=9) to assess each item using a score ranging from 1 to 9 based on increasing appropriateness. The expert-opinion process returned a whole mean score of 8.47+/-0.43 (95% confidence interval [CI] 8.30-8.63). Overall agreement, uncertainty, and disagreement between experts about item appropriateness were 98.5%, 1.49%, and 0%, respectively. Agreement/uncertainty for pretransplantation, transplantation, and posttransplantation items were 99.87%/0.12%, 100%/0%, and 96.37%/3.62%, respectively. This study supported the utility of a structured expert-opinion process as an effective strategy to evaluate the appropriateness of large datasets for kidney/pancreas transplantation in adult recipients.
authors.affiliation: Department of Transplantation, San Martino University Hospital, Genoa, Italy. gregorio.santori@gmail.com
authors.forename: G
authors.initials: G
authors.lastname: Santori
authors.forename: I
authors.initials: I
authors.lastname: Fontana
authors.forename: R
authors.initials: R
authors.lastname: Valente
authors.forename: R
authors.initials: R
authors.lastname: Ghirelli
authors.forename: U
authors.initials: U
authors.lastname: Valente
mesh_terms: D000328:Adult; D002140:California; D002985:Clinical Protocols; D016000:Cluster Analysis; D006801:Humans; D007256:Information Systems; D016030:Kidney Transplantation / Q000502:physiology*; D015141:Los Angeles; D016035:Pancreas Transplantation / Q000502:physiology*; D011300:Preoperative Care; D015203:Reproducibility of Results; D012984:Software; D016896:Treatment Outcome; D014495:Universities