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Development of explicit criteria for cholecystectomy
J M Quintana1, J Cabriada, I López de Tejada
1Unidad de Investigación, Hospital de Galdakao, Galdakao, Vizcaya, Spain. jmquinta@hgda.osakidetza.net
Quality & Safety in Health Care
|December 7, 2002
Summary
An updated tool for assessing cholecystectomy appropriateness in non-malignant diseases demonstrated good validity and reliability. This algorithm can effectively screen indications for gallbladder removal surgery.
Area of Science:
- Gastroenterology and Surgery
- Medical Decision Making
Background:
- Previous consensus criteria for cholecystectomy appropriateness were established in the late 1980s.
- Advancements in diagnostic and treatment techniques necessitate updated guidelines.
- This study focuses on cholecystectomy for non-malignant gallbladder diseases.
Purpose of the Study:
- To develop and validate an updated tool for assessing the appropriateness of cholecystectomy indications.
- To evaluate the validity and reliability of expert panel judgments using the new tool.
Main Methods:
- A modified Delphi panel process involving gastroenterologists and surgeons was employed.
- Panelists rated the appropriateness of 210 cholecystectomy scenarios.
- Inter-rater reliability was assessed using weighted kappa statistics and compared to a second panel.
Main Results:
- The developed tool resulted in 51% of scenarios rated as appropriate, 26% uncertain, and 23% inappropriate.
- Panel agreement was achieved in 54% of scenarios.
- A weighted kappa statistic of 0.75 indicated good agreement between the main and second panels.
Conclusions:
- The updated appropriateness of indications tool demonstrates acceptable validity and reliability.
- The algorithm is suitable for use as a screening tool to evaluate the necessity of cholecystectomy.