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Usefulness of consensus conferences: the case of albumin

I Durand-Zaleski1, F Bonnet, H Rochant

  • 1Department of Public Health, Hôpital Henri Mondor, Creteil, France.

Lancet (London, England)
|December 5, 1992
PubMed

Insights

Consensus conferences can improve medical practice by guiding treatment decisions. A 1989 conference on hypovolaemia significantly reduced albumin use and costs by 40% at one hospital.

Area of Science:

  • Medical Practice
  • Health Services Research

Background:

  • The effectiveness of consensus conferences in clinical practice has been debated.
  • Assessing the impact of consensus conferences on prescribing behavior is crucial for evidence-based medicine.

Purpose of the Study:

  • To evaluate the influence of a 1989 consensus conference on the treatment of hypovolaemia on albumin prescribing practices.
  • To determine the impact on albumin utilization and associated costs within a hospital setting.

Main Methods:

  • Utilized blood bank data to track albumin use and costs across departments from 1987 to 1991.
  • Disseminated conference recommendations through medical journals, direct mail, and meetings.
  • Focused on a specific consensus conference addressing hypovolaemia treatment guidelines.

Main Results:

  • Albumin use and costs decreased by 40% in the year following the conference and in subsequent years.
  • This reduction occurred despite rising overall medical expenditure and stable patient admission numbers.
  • Specific indications for albumin use were clarified, recommending alternatives for septic shock and vasoplegia-induced hypovolaemia.

Conclusions:

  • Consensus conferences can be effective tools for improving medical practice and optimizing resource allocation.
  • Key factors contributing to the success of this conference included a limited prescriber base, a homogeneous clinical setting, and consistent reinforcement of recommendations.

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