IMPACT OF VARYING PANEL MEMBERSHIP ON RATINGS OF APPROPRIATENESS IN CONSENSUS PANELS - A COMPARISON OF A MULTIDISCIPLINARY AND SINGLE-DISCIPLINARY PANEL

Objective. The objective of the study was to examine the appropriatene ss ratings for the use of spinal manipulation for low back pain of a m ultidisciplinary panel of medical and chiropractic physicians, and tho se of a panel composed only of chiropractic physicians. Data Sources. The study analyzed data from two consensus panels conducted at RAND in 1990 and 1991. Study Design. The study design followed that of the tr aditional RAND consensus panels. Nine individuals comprised each panel , and each panelist was asked to rate, on a nine-point scale, the indi cations for spinal manipulation twice, the first time alone and the se cond time jointly with the panel. Data Collection. The ratings of the panelists from both groups, for both round one and round two, were col lated and compared. Principal Findings. While both panels were more li kely to rate the indications as inappropriate than appropriate, the si ngle disciplinary panel was more likely to rate an indication as appro priate than the multidisciplinary panel. Conclusion, The composition o f a panel clearly influences the ratings and those who use a given pro cedure in practice, in this case manipulation, are more likely to rate it as appropriate than those who do not use the procedure.