GENERIC SURGICAL PRIORITY CRITERIA SCORING SYSTEM - THE CLINICAL REALITY

Aims. To assess the 'generic surgical priority criteria' (GSPC) introd uced into Auckland Hospital by the Northern Division of the Transition al Health Authority in 1997 and compare it with a score based on clini cal judgement obtained using a linear analogue scale (LAS). Methods. F rom the time of introduction in June 1997 all patients being placed on the general surgical waiting list have been scored using both the GSP C and the LAS. After two months the scores given to 209 patients were reviewed and compared. Correlation and limits of agreement analysis we re performed for grouped data, cancer and benign groups. Results. The data showed wide variation and poor agreement between the surgeons' cl inical judgement in assessing priority for surgery and the score patie nts obtained using the GSPC. Conclusion. The GSPC has poor diagnostic discrimination as it failed to identify reliably a cancer diagnosis as high priority, with benign diagnoses scoring consistently higher. Thi s highlights the need for clinical involvement in designing priority c riteria and for formal validation of such tools.