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Generic surgical priority criteria scoring system: the clinical reality
1Department of Surgery, Faculty of Medicine and Health Science, University of Auckland.
Aims:
To assess the 'generic surgical priority criteria' (GSPC) introduced into Auckland Hospital by the Northern Division of the Transitional Health Authority in 1997 and compare it with a score based on clinical judgement obtained using a linear analogue scale (LAS).
Methods:
From the time of introduction in June 1997 all patients being placed on the general surgical waiting list have been scored using both the GSPC and the LAS. After two months the scores given to 209 patients were reviewed and compared. Correlation and limits of agreement analysis were performed for grouped data, cancer and benign groups.
Results:
The data showed wide variation and poor agreement between the surgeons' clinical judgement in assessing priority for surgery and the score patients obtained using the GSPC.
Conclusion:
The GSPC has poor diagnostic discrimination as it failed to identify reliably a cancer diagnosis as high priority, with benign diagnoses scoring consistently higher. This highlights the need for clinical involvement in designing priority criteria and for formal validation of such tools.