Romanchuk Kennneth G, Sanmugasunderam Suren, Hadorn David C
Department of Ophthalmology, University of Saskatchewan.
Can J Ophthalmol. 2002 Apr;37(3):145-54. doi: 10.1016/s0008-4182(02)80056-4.
The Western Canada Waiting List Project (WCWL) is a federally funded partnership of 19 organizations, including medical associations, health authorities, ministries of health and research organizations, that was created to develop tools to assist in the management of waiting lists. The WCWL cataract surgery panel, one of five panels constituted under this project, developed and tested a set of standardized clinical criteria for prioritizing among patients awaiting cataract surgery.
The cataract surgery panel was composed of seven academic and community ophthalmologists, two family physicians, an optometrist, a health care services researcher and a health information specialist. The panel met three times between October 1999 and June 2000. The priority criteria were applied to 563 patients in the four western provinces. Regression analysis was used to determine the set of criteria weights that collectively best predicted clinicians' overall ratings of urgency. Interrater and test-retest reliability were assessed, based on clinicians' ratings of videotaped interviews with six hypothetical patients.
The resulting criteria accounted for about one-third of the observed variance in clinicians' ratings of overall clinical urgency (R2 = 31.2%). The panel modified the original criteria and weights based on empirical results and clinical judgement. Reliability of the revised criteria items was mixed, with the lowest reliability observed for items dealing with glare and social role.
Participating clinicians considered the criteria easy to use and reasonably reflective of expert surgical judgement regarding clinical urgency. Further development and testing of the tool appear warranted.
加拿大西部等候名单项目（WCWL）是一个由19个组织组成的联邦资助合作项目，其中包括医学协会、卫生当局、卫生部和研究机构，该项目旨在开发有助于管理等候名单的工具。WCWL白内障手术小组是根据该项目设立的五个小组之一，制定并测试了一套标准化临床标准，用于对等待白内障手术的患者进行优先级排序。
白内障手术小组由7名学术和社区眼科医生、2名家庭医生、1名验光师、1名医疗服务研究员和1名健康信息专家组成。该小组在1999年10月至2000年6月期间共召开了3次会议。优先级标准应用于西部四省的563名患者。采用回归分析来确定一组标准权重，这些权重共同能最好地预测临床医生对紧迫性的总体评分。基于临床医生对6名假设患者录像访谈的评分，评估了评分者间信度和重测信度。
所得标准约占临床医生对总体临床紧迫性评分中观察到的方差的三分之一（R2 = 31.2%）。该小组根据实证结果和临床判断对原始标准和权重进行了修改。修订后标准项目的信度参差不齐，处理眩光和社会角色的项目信度最低。
参与的临床医生认为这些标准易于使用，并且合理地反映了专家对临床紧迫性的手术判断。该工具似乎有必要进一步开发和测试。
