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Related Experiment Videos

When does consensus exist in expert panels?

E A Scott1, N Black

  • 1Department of Public Health and Policy, London School of Hygiene and Tropical Medicine.

Journal of Public Health Medicine
|February 1, 1991
PubMed
Summary
This summary is machine-generated.

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Expert panels help define good practice, but results vary with agreement definitions. Excluding outliers and using relaxed criteria for disagreement can increase consensus on cholecystectomy indications.

Area of Science:

  • Medical practice guidelines
  • Health services research
  • Surgical indications

Background:

  • Expert panels are increasingly utilized to establish consensus on clinical practice criteria.
  • The impact of varying definitions of agreement and disagreement on panel conclusions remains unclear.
  • Assessing consensus on indications for cholecystectomy serves as a model for evaluating panel methodology.

Purpose of the Study:

  • To investigate the sensitivity of expert panel conclusions to different definitions of agreement and disagreement.
  • To analyze how outlier inclusion/exclusion affects consensus on cholecystectomy indications.
  • To determine optimal definitions for enhancing clarity in quality assurance activities.

Main Methods:

  • Two expert panels convened to evaluate indications for cholecystectomy.

Related Experiment Videos

  • Analyses focused on the impact of including versus excluding outlier opinions.
  • Varied definitions of agreement and disagreement were applied to assess their influence on outcomes.

    • Main Results:

    • The level of agreement was significantly influenced by the inclusion or exclusion of outlier views.
    • Excluding outliers increased the proportion of appropriate cholecystectomy indications from approximately 40% to 60%.
    • The proportion of inappropriate indications identified was sensitive to the strictness of disagreement definitions used.

    Conclusions:

    • Eliminating outliers and employing more relaxed definitions of disagreement can enhance agreement levels in expert panels.
    • These methodological adjustments are favored for improving the utility of expert panels in quality assurance.
    • Findings provide insights into optimizing consensus-building processes for clinical practice guidelines.