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Appropriateness of Upper Gastrointestinal Endoscopy: Comparison of American and Swiss Criteria

VADER, JOHN-PAUL ; BURNAND, BERNARD ; FROEHLICH, FLORIAN ; DUPRIEZ, KARINE ; LAREQUILAUBER, TANIA ; PACHE, ISABELLE ; DUBOIS, ROBERT W. ; GONVERS, JEAN-JACQUES ; BROOK, ROBERT H.

In: International Journal for Quality in Health Care, 1997, vol. 9, no. 2, p. 87-92

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    Titre
    • Appropriateness of Upper Gastrointestinal Endoscopy: Comparison of American and Swiss Criteria
    Auteur
    • VADER, JOHN-PAUL. Institute of Social and Preventive Medicine, University of Lausanne CH-1005 Lausanne Switzerland
    • BURNAND, BERNARD. Institute of Social and Preventive Medicine, University of Lausanne CH-1005 Lausanne Switzerland
    • FROEHLICH, FLORIAN. Division of Gastroenterology, Policlinique médicale universitaire, University of Lausanne CH-1005 Lausanne Switzerland
    • DUPRIEZ, KARINE. Institute of Social and Preventive Medicine, University of Lausanne CH-1005 Lausanne Switzerland
    • LAREQUILAUBER, TANIA. Institute of Social and Preventive Medicine, University of Lausanne CH-1005 Lausanne Switzerland
    • PACHE, ISABELLE. Division of Gastroenterology, Policlinique médicale universitaire, University of Lausanne CH-1005 Lausanne Switzerland
    • DUBOIS, ROBERT W.. Division of Gastroenterology, Policlinique médicale universitaire, University of Lausanne CH-1005 Lausanne Switzerland
    • GONVERS, JEAN-JACQUES. Division of Gastroenterology, Policlinique médicale universitaire, University of Lausanne CH-1005 Lausanne Switzerland
    • BROOK, ROBERT H.. University of California (UCLA). School of Medicine and School of Public Health, Los Angeles, CA 90024,and RAND Corporation Santa Monica, CA 90407, USA
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • International Journal for Quality in Health Care, 1997, vol. 9, no. 2, p. 87-92. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:292118
    Summary
    Objective: Examine the reproducibility of the RAND method for developing criteria for the appropriateness of medical procedures. Design: Comparison of two sets of explicit criteria for appropriateness of upper gastrointestinal (UGI) endoscopy, developed by separate expert panels from two countries.Setting: United States, Switzerland. Study participants: National experts from different medical specialties involved in the referral or application of UGI endoscopy.Interventions: Each panel was presented with about 500clinical scenarios (indications)that were rated on a nine-point scale as to the appropriateness of performing UGI endoscopy for a patient with that clinical presentation. Main outcome measurer: (1) distribution of appropriateness ratings and intrapanel agreement categories between the two panels, (2)between-panel agreement of assigning appropriateness for comparable indications and, (3) percentage of indications with major between-panel differences. Results: Ratings for 2/3 of indications could be compared. The Swiss panel showed higher intrapanel agreement (54.6% versus 46.2% p=0.002). Seventy-eight percent of comparable Indications were assigned to indentical categories of appropriateness by both panels (kappa=0.76,P <0.001). For 93% of the 376 comparable indications, there were no major interpanel differences. Conclusion: Separate expert panels in different countries, using a standardized methodology, produce criteria for appropriatenesof medical procedures that are similar. Given the resources being invested throught the world in devilping criteria and guidelines, international collaboration in seeking optimal use of limited health care resources should be intensifled. © 1997 Elsevier Science Ltd. All rights reserved