Development of appropriateness criteria for colonoscopy: comparison between a standardized expert panel and an evidence-based medicine approach

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Ressource 1Download: serval:BIB_FA7574AB51E9.P001 (95.41 [Ko])
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It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_FA7574AB51E9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Development of appropriateness criteria for colonoscopy: comparison between a standardized expert panel and an evidence-based medicine approach
Journal
International Journal for Quality in Health Care
Author(s)
Nicollier-Fahrni  Anne, Vader  John-Paul, Froehlich  Florian, Gonvers  Jean-Jacques, Burnand  Bernard
ISSN
1353-4505
Publication state
Published
Issued date
2003
Volume
15
Number
1
Pages
15-22
Notes
Réf. IUMSP: R 03/13
SAPHIRID:44947 --- Old url value: http://intqhc.oupjournals.org/cgi/content/full/15/1/15
Abstract
OBJECTIVES: To assess the degree of agreement between appropriateness criteria for the use of colonoscopy developed by a standardized expert panel method and evidence from published studies. DESIGN: Descriptive, agreement study. SETTING: Multidisciplinary panel; primary care practice in Switzerland. PARTICIPANTS: Nine national experts; 577 primary care patients referred for colonoscopy, 154 published papers. INTERVENTIONS: Evaluation of the appropriateness of 402 possible clinical indications for colonoscopy, based on a comprehensive review of the literature. MAIN OUTCOMES MEASURES: Proportion of agreement (weighted kappa), between panel- and literature-based appropriateness categories (appropriate, uncertain, inappropriate) for theoretical and actual indications encountered. RESULTS: Nineteen of 402 indications rated by the panel could be based on the evidence retrieved from eight randomized clinical trials. A 68% agreement (kappa = 0.52) was found between panel- and study-based criteria. The addition of an uncontrolled trial and seven observational studies yielded a 71% agreement (kappa = 0.63). Agreement was similar when examining 577 actual cases: 69% agreement, kappa = 0.47. Agreement between panel-based indications and published evidence was not influenced by the perceived comprehensiveness and the apparent quality of the published reports. CONCLUSIONS: Evidence for the appropriateness of most indications for colonoscopy could not be derived directly from the published literature. Agreement between appropriateness criteria developed by an expert panel and evidence from published studies was moderate to good, where available. New approaches should be sought in order to systematically integrate complementary evidence obtained from clinical trials and expert panels into practice guidelines. [authors]
Pubmed
Web of science
Open Access
Yes
Create date
06/03/2008 16:31
Last modification date
25/09/2019 7:11
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