Use of statistical techniques to synthesize explicit criteria developed by an expert panel.

OBJECTIVES: Methodology based on expert panels has been commonly used to evaluate the appropriateness of interventions. An important issue is the adequate synthesis of the generated information in an applicable way to clinical decision making. This paper shows how statistical procedures help synthesize the results of an expert panel. METHODS: Three statistical techniques were applied to an expert panel that developed explicit criteria to assess the appropriateness of total hip joint replacement: classification tree, regression tree and multiple correspondence analysis combined with automatic classification. RESULTS: Results provided by the three models were shown in graphical displays and were compared to the original panel results using crude and weighted probability of misclassification. Results were also applied to real interventions in order to know the implication of the misclassification on real patients. CONCLUSIONS: The statistical techniques help summarize data from panels of experts and provide useful decision models for clinical practice, especially when the number of indications is big. However, degree of misclassification and its implication should be taken into account.

[Residents' assessment of education received in hospital departments: a monitoring tool]. / Evaluación por los médicos internos residentes de la formación recibida en los servicios hospitalarios: una herramienta de monitorización.

OBJECTIVE: [corrected] The Spanish postgraduate medical education system has made great contributions to the development of the National Health Service. Despite recent regulations on critical aspects of this education system, there still remains a need for a global assessment process. Hospital services evaluation by the residents should play a part in this process. METHODS: Administration over three years in a general teaching hospital of a specific questionnaire devoted to measure residents' perceptions of tthe medical education provided by their own service or department. Only residents who had stayed at least one year in their service were allowed to participate. Multivariable analyses using Multiple Correspondence Analysis (MCA) and Automatic Classification (AC) methods were performed. RESULTS: The overall response rate was 66.6% (325/488). 84,7% of the respondents deemed the overall education received as either adequate or excellent. The better scored aspects were patient management education, ethics education and residents' patient care supervision (more than 80% responses rating them as adequate/excellent). Performance of interdepartamental and bibliographic sessions along with research education were the worse perceived aspects by residents (less than 50% of responses as adequate/excellent). A factorial plane that explained 95% of overall response variability and allowed to rank the residents according to their assessment of education was obtained. Services with utmost ratings were found. AC results showed that were three different groups on the basis of overall peception of education received: The first group (18.2%) deemed it as excellent, the second group (61.5%) as adequate, while the thrid group (20.3%) considered it as inadequate. CONCLUSIONS: The administration of this questionnaire to hospital's residents and the analysis of its results using specific multivariable techniques provides useful information in order to monitor postgraduate medical education programmes and detect areas of improvement.

Evaluación por los médicos internos residentes de la formación recibida en los servicios hospitalarios: una herramientade monitorización / Residents’ assessment of education received in hospital departments: a monitoring tool)

Objetivo: El sistema de formación médica posgraduada en España, basado en la figura del médico interno residente (MIR)ha contribuido a la mejora y desarrollo del Sistema Nacional de Salud. A pesar de su reciente reglamentación (Orden Ministerial de 22 de junio de 1995), el sistema MIR continúa careciendo de un proceso integral y completo de evaluación. La evaluación por los MIR de los servicios hospitalarios debe formar parte de dicho proceso. Métodos: Administración durante 3 años de una encuesta de evaluación de su servicio hospitalario a los MIR de un hospital terciario que hubieran estado al menos un año en dicho servicio. Análisis y presentación de resultados usando análisis de correspondencias múltiples (ACM) y métodos de clasificación automática (CA).Resultados: Se obtuvieron 325 encuestas cumplimentadas de 488 enviadas (tasa de respuesta: 66,6%). La valoración global de la formación recibida fue adecuada o excelente (..) (AU)

Objetive: The Spanish postgraduate medical education system has made great contributions to the development of the National Health Service. Despite recent regulations on critical aspects of this education system, there still remains a need for a global assessment process. Hospital services evaluation by the residents should play a part in this process. Methods: Administration over three years in a general teaching hospital of a specific questionnaire devoted to measure residents’ perceptions of the medical education provided by their own service or department. Only residents who had stayed at least one year in their service were allowed to participate. Multivariable analyses using Multiple Correspondence Analysis (MCA) and Automatic Classification (AC) methods were performed. Results: The overall response rate was 66.6% (325/488).84,7% of the respondents deemed the overall education received as either adequate or excellent. The better scored aspects were patient management education, ethics education and residents’ patient care supervision (more than80% responses rating them as adequate/excellent). Performance of interdepartamental and bibliographic sessions (..) (AU)