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Titolo:
Sensitivity and specificity of the RAND/UCLA Appropriateness Method to identify the overuse and underuse of coronary revascularization and hysterectomy
Autore:
Shekelle, PG; Park, RE; Kahan, JP; Leape, LL; Kamberg, CJ; Bernstein, SJ;
Indirizzi:
Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90066 USA Greater Los Angeles VA Healthcare Syst Los Angeles CA USA 90066 90066 USA RAND, Santa Monica, CA 90401 USA RAND Santa Monica CA USA 90401RAND, Santa Monica, CA 90401 USA Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 niv, Sch Publ Hlth, Boston, MA 02115 USA Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA Univ Michigan Ann Arbor MI USA 48109 nternal Med, Ann Arbor, MI 48109 USA Univ Michigan, Dept Hlth Management, Ann Arbor, MI 48109 USA Univ Michigan Ann Arbor MI USA 48109 Management, Ann Arbor, MI 48109 USA Univ Michigan, Dept Policy, Ann Arbor, MI 48109 USA Univ Michigan Ann Arbor MI USA 48109 Dept Policy, Ann Arbor, MI 48109 USA Ann Arbor VA Healthcare Syst, Ann Arbor, MI 48105 USA Ann Arbor VA Healthcare Syst Ann Arbor MI USA 48105 n Arbor, MI 48105 USA
Titolo Testata:
JOURNAL OF CLINICAL EPIDEMIOLOGY
fascicolo: 10, volume: 54, anno: 2001,
pagine: 1004 - 1010
SICI:
0895-4356(200110)54:10<1004:SASOTR>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEW-YORK-STATE; BYPASS GRAFT-SURGERY; CAROTID ENDARTERECTOMY; MEDICAL PROCEDURES; ANGIOGRAPHY; CARE; VALIDITY; CRITERIA; DISEASE; RISK;
Keywords:
quality of health care; sensitivity and specificity; coronary revascularization; hysterectomy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Shekelle, PG 1700 Main St,POB 2138, Santa Monica, CA 90407 USA 1700 Main St,POB 2138 Santa Monica CA USA 90407 CA 90407 USA
Citazione:
P.G. Shekelle et al., "Sensitivity and specificity of the RAND/UCLA Appropriateness Method to identify the overuse and underuse of coronary revascularization and hysterectomy", J CLIN EPID, 54(10), 2001, pp. 1004-1010

Abstract

There is no empirical evidence on the sensitivity and specificity of methods to identify the possible overuse and underuse of medical procedures. To estimate the sensitivity and specificity of the RAND/UCLA Appropriateness Method. Parallel three-way replication of the RAND/UCLA Appropriateness Method for each of two procedures, coronary revascularization and hysterectomy. Maximum likelihood estimates of the sensitivity and specificity of the method for each procedure. These values were then used to re-calculate past estimates of overuse and underuse, correcting for the error rate in the appropriateness method. The sensitivity of detecting overuse of coronary revascularization was 68% (95% confidence interval 60-76%) and the specificity was99% (98-100%). The corresponding values for hysterectomy were 89% (85-94%)and 86% (83-89%). The sensitivity and specificity of detecting the underuse of coronary revascularization were 94% (92-95%) and 97% (96-98%), respectively. Past applications of the appropriateness method have overestimated the prevalence of the over-use of hysterectomy, underestimated the prevalence of the overuse of the coronary revascularization. and provided true estimates of the underuse of revascularization. The sensitivity and specificity of the RAND/UCLA Appropriateness Method vary according to the procedure assessed and appear to estimate the underuse of procedures more accurately than their overuse. (C) 2001 Elsevier Science Inc. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 15:45:01