Summary
Objectives:
Methodology based on expert panels has been commonly used to evaluate the appropriateness
of interventions. An important issue is the adequate synthesis of the generated information
in an applicable way to clinical decision making. This paper shows how statistical
procedures help synthesize the results of an expert panel.
Methods:
Three statistical techniques were applied to an expert panel that developed explicit
criteria to assess the appropriateness of total hip joint replacement: classification
tree, regression tree and multiple correspondence analysis combined with automatic
classification.
Results:
Results provided by the three models were shown in graphical displays and were compared
to the original panel results using crude and weighted probability of misclassification.
Results were also applied to real interventions in order to know the implication of
the misclassification on real patients.
Conclusions:
The statistical techniques help summarize data from panels of experts and provide
useful decision models for clinical practice, especially when the number of indications
is big. However, degree of misclassification and its implication should be taken into
account.
Keywords
Appropriateness - statistical models - classification error - clinical guidelines
