Coulter I, Adams A, Shekelle P
RAND, Santa Monica, CA 90407-2138, USA.
Health Serv Res. 1995 Oct;30(4):577-91.
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.
The study analyzed data from two consensus panels conducted at RAND in 1990 and 1991.
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.
The ratings of the panelists from both groups, for both round one and round two, were collated and compared.
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.
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.
本研究的目的是考察医学和整脊医师多学科小组以及仅由整脊医师组成的小组对使用脊柱推拿治疗腰痛的适宜性评级。
该研究分析了1990年和1991年在兰德公司进行的两个共识小组的数据。
该研究设计遵循传统的兰德共识小组的设计。每个小组由九名成员组成，要求每位小组成员在九点量表上对脊柱推拿的适应症进行两次评分，第一次单独评分，第二次与小组共同评分。
对两组小组成员在第一轮和第二轮的评分进行整理和比较。
虽然两个小组都更倾向于将适应症评为不适当而非适当，但单一学科小组比多学科小组更倾向于将适应症评为适当。
小组的组成明显影响评级，在实际中使用特定程序（在这种情况下是推拿）的人比不使用该程序的人更倾向于将其评为适当。
