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ARE EXPERT PANEL JUDGMENTS OF MEDICAL BENEFITS RELIABLE?

An Evaluation of Emergency Medical Service Programs

Published online by Cambridge University Press:  22 January 2003

Ragnar Hotvedt ,
Hans Morten Lossius ,
Ival Sønbø Kristiansen ,
Petter Andreas Steen ,
Eldar Søreide  and
Olav Helge Førde
Ragnar Hotvedt
Affiliation:
University of Tromsø
Hans Morten Lossius
Affiliation:
Rogaland Central Hospital
Ival Sønbø Kristiansen
Affiliation:
University of Southern Denmark
Petter Andreas Steen
Affiliation:
Ullevål Hospital
Eldar Søreide
Affiliation:
Rogaland Central Hospital
Olav Helge Førde
Affiliation:
University of Tromsø
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Abstract

Objective: We have used multidisciplinary expert panels to assess the health benefits from two different emergency medical service programs in Norway. This gave the opportunity to study the reliability of the expert panel method.

Methods: Two panels assessed case reports for 18 children, and two other panels assessed case reports for 64 adult patients. The assessments of each case report were compared. These assessments were also compared with assessments of the same case reports, done by the same panels 1 and 9 years earlier.

Results: Two different panels agreed on the benefit/no benefit conclusion in at least 75% of the patients, both for children and adult patients (kappa 0.88–0.50). For groups of patients assessed to have some health benefit, the magnitude of the benefit estimates differed by 25% between the panels. When the same panels assessed the same patient groups twice, 1 and 9 years apart, their estimates of total benefit differed up to 30%. However, estimates for single patients, as well as estimates from single panel members, varied considerably more.

Conclusions: Use of multidisciplinary expert panels is a useful method for estimating health benefits on program level or for groups of patients. But assessments from single panelists, and for single patients may be seriously biased.

Keywords

ReliabilityReproducibility of resultsResearch designsGroup processesEmergency medical services
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 19 , Issue 1 , January 2003 , pp. 158 - 167
Copyright
© 2003 Cambridge University Press

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