Impact of varying panel membership on ratings of appropriateness in consensus panels: a comparison of a multi- and single disciplinary panel.

摘要

OBJECTIVE. The objective of the study was to examine the appropriateness ratings for the use of spinal manipulation for low back pain of a multidisciplinary panel of medical and chiropractic physicians, and those of a panel composed only of chiropractic physicians. DATA SOURCES. The study analyzed data from two consensus panels conducted at RAND in 1990 and 1991. STUDY DESIGN. The study design followed that of the traditional RAND consensus panels. Nine individuals comprised each panel, and each panelist was asked to rate, on a nine-point scale, the indications for spinal manipulation twice, the first time alone and the second time jointly with the panel. DATA COLLECTION. The ratings of the panelists from both groups, for both round one and round two, were collated and compared. PRINCIPAL FINDINGS. While both panels were more likely to rate the indications as inappropriate than appropriate, the single disciplinary panel was more likely to rate an indication as appropriate than the multidisciplinary panel. CONCLUSION. The composition of a panel clearly influences the ratings and those who use a given procedure in practice, in this case manipulation, are more likely to rate it as appropriate than those who do not use the procedure.