Influence of clinical and economical factors on the expert rating of appropriateness of preoperative use of recombinant erythropoietin in elective orthopedic surgery patients

Détails

ID Serval
serval:BIB_AE2F50D5B164
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Influence of clinical and economical factors on the expert rating of appropriateness of preoperative use of recombinant erythropoietin in elective orthopedic surgery patients
Périodique
Medical Decision Making
Auteur(s)
Taffé  Patrick, Burnand  Bernard, Wietlisbach  Vincent, Vader  John-Paul
ISSN
0272-989X
Statut éditorial
Publié
Date de publication
2004
Volume
24
Numéro
2
Pages
122-130
Notes
Réf. IUMSP: R 04/32
SAPHIRID:44720
Résumé
To evaluate the relative impact of clinical factors and health care environment resources on the expert ratings of appropriateness of preoperative erythropoietin in elective orthopedic surgery, the authors analyzed 6905 individual votes on 496 clinical scenarios from 14 experts, applying a multivariate logistic model. Sixty-six percent of the indications were appropriate when resource constraints (RC) were not considered and 53% when they were, resulting in a drop in the median vote of 2 points on a 9-point scale (P < 0.05). Initial hemoglobin level, expected perioperative blood loss, and RC were by far the most significant contributors to the model (P < 0.01), but other factors (i.e., clinical specialty of the expert, prior history of transfusion reactions, patient age, cardiovascular disease, anemia of chronic disease) also contributed significantly (P< 0.01). For assessing appropriateness of care, this study confirms the need for detailed clinical scenarios and a multidisciplinary panel carefully selected to reflect those involved in the interventions under consideration. [authors]
Pubmed
Web of science
Création de la notice
05/03/2008 15:57
Dernière modification de la notice
20/08/2019 15:18
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