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Results of a Swiss consensus conference on coronary revascularization


Schilling, Julian (1997). Results of a Swiss consensus conference on coronary revascularization. Swiss Medical Weekly, 127(27-28):1191-210.

Abstract

Percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) are major coronary revascularization procedures to relieve angina, prevent myocardial infarction and improve long-term survival. The quality of their indication is widely discussed at present. The Swiss Societies of Cardiology, of Internal Medicine and of Thoracic and Cardiovascular Surgery decided to set up a consensus conference to evaluate the indications for coronary revascularization. For this a modified RAND approach (Delphi method) was used. An expert panel rated 992 indications for coronary revascularization twice for appropriateness (more benefits than risks for the patient), and once for necessity (procedure has to be offered or discussed with the patient). In the panel an agreement percentage of 65% was noted. In 35% we observed neither agreement nor disagreement, and there was almost no disagreement among the panelists. The results of the necessity ratings were 48% agreement, 49% indetermination and 3% disagreement. The average median rating for appropriateness on a 1-9 point scale (1 = extremely inappropriate, 9 = extremely appropriate or necessary) was 7.7 over all given single indications and 7.2 for necessity. The results of appropriateness and necessity ratings presented in this paper reflect the findings of a 15-member Swiss panel.

Abstract

Percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) are major coronary revascularization procedures to relieve angina, prevent myocardial infarction and improve long-term survival. The quality of their indication is widely discussed at present. The Swiss Societies of Cardiology, of Internal Medicine and of Thoracic and Cardiovascular Surgery decided to set up a consensus conference to evaluate the indications for coronary revascularization. For this a modified RAND approach (Delphi method) was used. An expert panel rated 992 indications for coronary revascularization twice for appropriateness (more benefits than risks for the patient), and once for necessity (procedure has to be offered or discussed with the patient). In the panel an agreement percentage of 65% was noted. In 35% we observed neither agreement nor disagreement, and there was almost no disagreement among the panelists. The results of the necessity ratings were 48% agreement, 49% indetermination and 3% disagreement. The average median rating for appropriateness on a 1-9 point scale (1 = extremely inappropriate, 9 = extremely appropriate or necessary) was 7.7 over all given single indications and 7.2 for necessity. The results of appropriateness and necessity ratings presented in this paper reflect the findings of a 15-member Swiss panel.

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7 citations in Scopus®
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Additional indexing

Contributors:Swiss Society of Cardiology, Swiss Society of Internal Medicine, Swiss Society of Thoracic and Cardiovascular Surgery
Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:8 July 1997
Deposited On:10 Jun 2016 09:40
Last Modified:08 Dec 2017 19:39
Publisher:EMH Swiss Medical Publishers
ISSN:0036-7672
PubMed ID:9260297

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