Scott E A, Black N
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine.
J Public Health Med. 1991 Feb;13(1):35-9. doi: 10.1093/oxfordjournals.pubmed.a042575.
Increasingly, expert panels are being used to determine whether or not a consensus exists about criteria of good practice. It is, however, unclear how sensitive the panels' conclusions are to changes in the definitions of agreement and disagreement used. To explore this, two expert panels were established to assess the appropriate indications for cholecystectomy. Analyses of the results showed that the level of agreement depended on whether or not the views of outliers were included or eliminated. Exclusion of outliers increased the proportion of appropriate indications from about 40 per cent to 60 per cent. In contrast, the proportion of indications felt to be inappropriate was dependent on how strict the definitions employed were. Given that the principal purpose of expert panels is to inform quality assurance activities, the higher levels of agreement and disagreement achieved by eliminating outliers and employing more relaxed definitions are to be favoured.
越来越多地，专家小组被用于确定关于良好实践标准是否存在共识。然而，尚不清楚专家小组的结论对所使用的同意和不同意定义的变化有多敏感。为了探究这一点，成立了两个专家小组来评估胆囊切除术的适当指征。对结果的分析表明，一致程度取决于异常值的观点是被纳入还是被排除。排除异常值使适当指征的比例从约40%提高到60%。相比之下，被认为不适当的指征比例取决于所采用定义的严格程度。鉴于专家小组的主要目的是为质量保证活动提供信息，通过排除异常值和采用更宽松的定义所实现的更高水平的同意和不同意是更可取的。
