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Effect of panel composition on appropriateness ratings
G M Fraser1, D Pilpel, J Kosecoff
1Department of Gastroenterolgy, Faculty of Health Sciences, Ben Gurion University, Soroka Medical Center, Beer-Sheva, Israel.
Summary
Panel composition significantly impacts cholecystectomy appropriateness ratings. Surgeons favored more indications, while gastroenterologists were more conservative, highlighting the influence of specialty and nationality on surgical appropriateness.
Area of Science:
- Surgical appropriateness assessment
- Medical decision-making
Background:
- Cholecystectomy is a common procedure with limited established indications.
- Previous studies suggest variations in appropriateness ratings based on panel composition.
Purpose of the Study:
- To evaluate how the composition of expert panels influences the assessment of appropriateness for cholecystectomy indications.
- To compare the perspectives of surgical versus mixed-specialty panels.
Main Methods:
- Utilized expert panels (surgical and mixed-specialty) to rate the appropriateness of cholecystectomy indications.
- Compared agreement levels on indications and contraindications across different panel compositions.
- Analyzed variations based on subspecialty (gastroenterologists vs. generalists/surgeons) and nationality (British vs. Israeli panels).
Main Results:
- An all-surgical panel agreed on more indications and fewer contraindications than a mixed-specialty panel.
- Mixed panels showed subspecialists (gastroenterologists) to be more conservative than generalists and surgeons.
- National differences (British vs. Israeli panels) also revealed variations in appropriateness ratings.
Conclusions:
- The composition of expert panels, including specialty mix and nationality, significantly influences the assessment of appropriateness for cholecystectomy.
- Understanding these variations is crucial for standardizing surgical practice and improving patient care guidelines.