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Related Experiment Videos

Reliability study of the European appropriateness evaluation protocol.

S Lorenzo1, T Lang, R Pastor

  • 1Fundación Hospital Alcorcón, Madrid, Spain. slorenzo@fhalcorcon.es

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
|November 24, 1999
PubMed
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The European version of the Appropriateness Evaluation Protocol (EU-AEP) demonstrates substantial reliability for utilization review across European countries. This tool supports harmonized research and comparative studies in healthcare settings.

Area of Science:

  • Health Services Research
  • Medical Informatics
  • Quality Improvement

Background:

  • Healthcare utilization review is crucial for resource management and quality assurance.
  • The US Appropriateness Evaluation Protocol (AEP) is a widely used tool for assessing healthcare utilization.
  • Adapting international tools requires rigorous validation for regional applicability.

Purpose of the Study:

  • To adapt the US Appropriateness Evaluation Protocol (AEP) for European healthcare settings, creating the EU-AEP.
  • To assess the inter-rater reliability of the European version of the AEP (EU-AEP).
  • To evaluate the EU-AEP's suitability for harmonizing and coordinating utilization review research in Europe.

Main Methods:

  • Nineteen medical records were reviewed by six physician reviewers from Austria, France, Italy, Spain, Switzerland, and the UK.

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  • Reviewers assessed the appropriateness of 19 admissions and 31 hospitalization days using the EU-AEP instrument.
  • Inter-rater reliability was evaluated using the kappa statistic for admission and day-of-care appropriateness.

    • Main Results:

    • The overall kappa statistic for admission appropriateness was 0.64 (range: 0.46-0.86).
    • The overall kappa statistic for day-of-care appropriateness was 0.59 (range: 0.25-0.95).
    • These kappa values indicate substantial agreement among reviewers.

    Conclusions:

    • The EU-AEP demonstrates substantial reliability in the European context, supporting its use in utilization review.
    • The instrument is suitable for comparative studies involving multiple European countries.
    • Preliminary findings support the EU-AEP as a reliable tool for harmonizing European healthcare research despite study limitations.