Hostname: page-component-76fb5796d-22dnz Total loading time: 0 Render date: 2024-04-26T02:59:24.223Z Has data issue: false hasContentIssue false
  • English
  • Français

An experimental study of the influence of individual participant characteristics on formal consensus development

Published online by Cambridge University Press:  18 January 2007

James Carpenter ,
Andrew Hutchings ,
Rosalind Raine  and
Colin Sanderson
James Carpenter
Affiliation:
London School of Hygiene & Tropical Medicine
Andrew Hutchings
Affiliation:
London School of Hygiene & Tropical Medicine
Rosalind Raine
Affiliation:
University College London
Colin Sanderson
Affiliation:
London School of Hygiene & Tropical Medicine
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The aim of this study was to examine the influence of participants' characteristics on the results produced by formal consensus methods.

Methods: The approach was an experimental study of 346 participants in 20 groups rating the appropriateness of four mental health interventions for the treatment of chronic fatigue syndrome, irritable bowel syndrome, and chronic back pain. There were four factors in the design: systematic literature review provided or not, decisions made under realistic or “ideal” resource assumptions, clinically mixed (general practitioners and mental health professionals) or homogenous group (general practitioners only), convened or mail-only group. A group's rating was defined as the median of participants' ratings. The influence of participants' characteristics (age, sex, and specialty) was examined using multilevel models.

Results: The largest differences were between the GPs and mental health professionals, both in their initial ratings of the different interventions, and in how much they altered their ratings between rounds. There were smaller but statistically significant (p<.05) differences between specialty and age groups in initial ratings for the treatment (by whatever means) of different conditions, and for certain conditions women increased their ratings more than men. Women rated intervention more favorably when assuming “ideal” rather than realistic levels of resources, but men did not.

Conclusions: Our findings support the practice of treating professional specialty as an important determinant of the results in consensus panels.

Keywords

Consensus methodsDelphi techniqueProfessional roleSexAge groups
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 23 , Issue 1 , January 2007 , pp. 108 - 115
Copyright
© 2007 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brook RH, Chassin MR, Fink A, et al. 1986 A method for the detailed assessment of the appropriateness of medical technologies. Int J Technol Assess Health Care. 2: 53– 63.Google Scholar
Burgers JS, Grol R, Klazinga NS, Makela M, Zaat J, for the AGREE collaboration. 2003 Towards evidence-based clinical practice: An international survey of 18 clinical guideline programs. Int J Qual Health Care. 15: 31– 45.Google Scholar
Chan BT, Austin PC. 2003 Patient, physician and community factors affecting referrals to specialists in Ontario, Canada: A population-based, multi-level modelling approach. Med Care. 41: 500– 511.Google Scholar
Coulter I, Adams A, Shekelle P. 1995 Impact of varying panel membership on ratings of appropriateness in consensus panels: A comparison of a multi- and single disciplinary panel. Health Serv Res. 30: 577– 591.Google Scholar
Goldstein H. 1995. Multilevel statistical models. London: Arnold;
Hutchings A, Raine R. 2006 A systematic review of factors affecting the judgments produced by formal consensus development methods in health care. J Health Serv Res Policy. 11: 172– 179.Google Scholar
Hutchings A, Raine R, Sanderson C, Black N. 2005 An experimental study of determinants of the extent of disagreement within clinical guideline development groups. Qual Saf Health Care. 14: 240– 245.Google Scholar
Hutchings A, Raine R, Sanderson C, Black N. 2006 A comparison of formal consensus methods used for developing clinical guidelines. J Health Serv Res Policy. 11: 218– 224.Google Scholar
Kahan JP, Bernstein SJ, Leape LL, et al. 1994 Measuring the necessity of medical procedures. Med Care. 32: 357– 365.Google Scholar
Kahan JP, Park RE, Leape LL, et al. 1996 Variations by specialty in physician ratings of the appropriateness and necessity of indications for procedures. Med Care. 34: 512– 523.Google Scholar
McKinlay JB, Burns RB, Durante R, et al. 1997 Patient, physician and presentational influences on clinical decision making for breast cancer: Results from a factorial experiment. J Eval Clin Pract. 3: 23– 57.Google Scholar
McKinlay JB, Lin T, Freund K, Moskowitz M. 2002 The unexpected influence of physician attributes on clinical decisions: Results of an experiment. J Health Soc Behav. 43: 92– 106.Google Scholar
MLwiN [computer program]. Version 2.0. 2000. London: Institute of Education;
Murphy MK, Black NA, Lamping DL, et al. 1998 Consensus development methods, and their use in clinical guideline development. Health Technol Assess. 2: 1– 88.Google Scholar
Park RE, Fink A, Brook RH, et al. 1986 Physician ratings of appropriate indications for six medical and surgical procedures. Am J Public Health. 76: 766– 772.Google Scholar
Raine R, Haines A, Sensky T, et al. 2002 Systematic review of mental health interventions for patients with common somatic symptoms: Can research evidence from secondary care be extrapolated to primary care? BMJ. 325: 1082– 1085.Google Scholar
Raine R, Sanderson C, Hutchings A, et al. 2004 An experimental study of determinants of group judgments in clinical guideline development. Lancet. 364: 429– 437.Google Scholar
Richardson FM. 1972 Peer review of medical care. Med Care. 10: 29– 39.Google Scholar
Scott EA, Black N. 1991 Appropriateness of cholecystectomy in the United Kingdom: A consensus panel approach. Gut. 32: 1066– 1070.Google Scholar
Taffé P, Burnand B, Wietlisbach V, Vader JP. 2004 Influence of clinical and economical factors on the expert rating of appropriateness of preoperative use of recombinant erythropoietin in elective orthopedic surgery patients. Med Decis Making. 24: 122– 130.Google Scholar