Publications by authors named "J B Kosecoff"
Background: Prospective data describing the appropriateness of use of colonoscopy based on detailed panel-based clinical criteria are not available.
Methods: In a cohort of 553 consecutive patients referred for colonoscopy to two university-based Swiss outpatient clinics, the percentage of patients who underwent colonoscopy for appropriate, equivocal, and inappropriate indications and the relationship between appropriateness of use and the presence of relevant endoscopic lesions was prospectively assessed. This assessment was based on criteria of the American Society for Gastrointestinal Endoscopy and explicit American and Swiss criteria developed in 1994 by a formal panel process using the RAND/UCLA appropriateness method.
Objective: To determine the appropriateness of intention to treat decisions concerning coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA) for patients with coronary artery disease in The Netherlands.
Design: Prospective study of intention to treat decisions using a computerised expert system.
Setting: "Presentation" sessions in 10 tertiary referral heart centres in 1992.
Background & Aims: Efforts to reduce costs in health care may raise concerns about underuse of medical procedures. This study prospectively assessed underuse of upper gastrointestinal endoscopy in a cohort of patients in whom we have recently published data on overuse of endoscopy.
Methods: Underuse was identified by formal necessity criteria for endoscopy, obtained by an explicit panel process.
Appropriateness of indications for surgery of lumbar disc hernia and spinal stenosis.
Spine (Phila Pa 1976)
January 1997
Study Design: This prospective study examines the appropriateness of indications for surgery of herniated intervertebral disc and spinal stenosis in patients undergoing surgery in a university hospital setting.
Objective: To evaluate the appropriateness of surgery using explicit criteria developed by an expert panel in the United States.
Summary Of Background Data: The use of surgery for herniated intervertebral disc and spinal stenosis varies widely within and among countries.
Background: This prospective observational study was aimed at evaluating the appropriateness of use of upper gastrointestinal endoscopy (UGE) in primary care in a country with open access to and high availability of the procedure.
Methods: Outpatients were consecutively included in two clinical settings: Setting A (20 primary care physicians during 4 weeks) and B (university-based outpatient clinic during 3 weeks). In patients undergoing UGE, appropriateness of referral was judged by explicit Swiss criteria developed by the RAND/UCLA panel method.