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Related Experiment Videos

Global judgments versus decision-model-facilitated judgments: are experts internally consistent?

E Z Oddone1, G Samsa, D B Matchar

  • 1Center for Health Policy Research and Education, Duke University, Durham, NC 27706.

Medical Decision Making : an International Journal of the Society for Medical Decision Making
|January 1, 1994
PubMed
Summary

Decision models enhance expert panel ratings for medical procedure appropriateness. Expert judgments on probabilities and utilities strongly correlated with global ratings, improving clinical guideline development.

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Area of Science:

  • Medical Decision Making
  • Health Technology Assessment
  • Clinical Guideline Development

Background:

  • The modified Delphi method, relying on expert global ratings, is common for assessing medical procedure appropriateness.
  • Challenges with global ratings prompt exploration of alternative methods like decision models.

Purpose of the Study:

  • To compare expert panel global ratings with decision-analytic model outputs for medical procedure appropriateness.
  • To evaluate the impact of decision models on expert panel assessments.

Main Methods:

  • Expert panelists provided global ratings for carotid endarterectomy appropriateness across 17 patient scenarios.
  • A decision-analytic model was constructed using expert-estimated probabilities and utilities.

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Main Results:

  • Expert panelists showed calibration variability between global ratings and model-derived expected utilities.
  • Model-derived expected utilities were generally higher than global ratings.
  • A strong correlation (Spearman's rho = 0.88) was observed between median global utility and median model-derived expected utility.

Conclusions:

  • Expert panel appropriateness ratings and expected utilities derived from decision models are highly correlated.
  • Decision models show internal consistency with expert judgments, aiding discordance reconciliation.
  • Decision models can enhance expert panels' understanding and satisfaction in clinical guideline development.