OBJECTIVE To examine the appropriateness and necessity of colonoscopy across Europe. DESIGN Prospective observational study. SETTING A total of 21 gastrointestinal centers from 11 countries. PARTICIPANTS Consecutive patients referred for colonoscopy at each center. INTERVENTION Appropriateness criteria developed by the European Panel on the Appropriateness of Gastrointestinal Endoscopy,...

BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) often experience exacerbations of the disease that require hospitalization. Current guidelines offer little guidance for identifying patients whose clinical situation is appropriate for admission to the hospital, and properly developed and validated severity scores for COPD exacerbations are lacking. To address these importan...

OBJECTIVE To update the Guideline for the Introduction of New Drugs in the Formulary (GINF form) using the RAND/UCLA appropriateness method, which combines the best available evidence and an expert panel's judgement. STUDY DESIGN/METHODS Two procedures were employed to detect where improvements could be made to the former versions of the request form and to transform them into concrete scenar...

BACKGROUND The majority of patient contacts occur in general practice but general practice patient safety has been poorly described and under-researched to date compared to hospital settings. Our objective was to produce a set of patient safety tools and indicators that can be used in general practices in any healthcare setting and develop a 'toolkit' of feasible patient safety measures for gen...

BACKGROUND Cholecystectomy use varies moderately across regions and countries. The purpose of this study was to evaluate the appropriateness of the use of cholecystectomy in patients with nonmalignant diseases in different hospitals using explicit criteria developed by an expert panel. METHODS Patients on waiting lists to undergo a cholecystectomy for nonmalignant diseases in six public hospi...

BACKGROUND Development of a manual or well-defined criterion for prioritizing the topics of clinical practice guidelines (CPGs) will help validate and organize this process evermore. This study was conducted to design an applicable manual that would prioritize the CPG topics for family physicians. METHODS This study was a multi-stage method using a qualitative approach that was conducted for ...

Objective—To develop review criteria to assess the quality of care for three major chronic diseases: adult asthma, stable angina, and non-insulin dependent diabetes mellitus. Subjects and methods—Modified panel process based upon the RAND/UCLA (University College of Los Angeles) appropriateness method. Three multiprofessional panels made up of general practitioners, hospital specialists, and pr...

BACKGROUND In the UK, a process of revalidation is being introduced to allow doctors to demonstrate that they meet current professional standards, are up-to-date, and fit to practise. Given the serious risks to patients from hazardous use of medicines it will be appropriate, as part of the revalidation process, to assess the safety of prescribing by GPs. AIM To identify a set of potential pre...

BACKGROUND Some UK GPs are acquiring access to natriuretic peptide (NP) testing or echocardiography as diagnostic tests for heart failure. This study developed appropriateness ratings for the diagnostic application of these tests in routine general practice. AIM To develop appropriateness ratings for the diagnostic application of NP testing or echocardiography for heart failure in general pra...