[Estimation of appropriateness of colonoscopy using RAND/UCLA method].

Multicenter European trials estimating appropriateness of colonoscopy are one of the hot topics in gastroenterology. The aim of the study was the estimation of appropriateness of colonoscopy and usefulness of panel experts criteria (elaborated according to RAND/UCLA method) in Department of Gastroenterology of Medical University of Silesia in Katowice and other gastroenterology centers throughout Europe. The trial was conducted between January 1st 2001 and May 30th 2001 in 18 centers in 9 European countries. 307 patients, who signed informed consent, were recruited in Katowice, while 5697 patients were enrolled in the other centers. The data have been collected in a prospective manner on a dedicated sheet, prepared in the coordinating centre in Lausanne (Switzerland). The part of the sheet with evaluation of appropriateness of colonoscopy was filled in before the procedure. The endoscopic (and histopathologic if necessary) diagnosis was collected after the procedure. The data from all centers were analyzed in Lausanne and the results were sent to the participants. The comparison of results from Katowice and of all the other centers was performed in Katowice. We found out, that self-estimation (made by colonoscopist), but also what is much more important the estimation done according to objective criteria of the panel of experts were significantly higher in our department, than in the other participating centers. The overestimation of self-judgment has been significantly higher in the other centers, than in our department. The higher percentage of therapeutic colonoscopies in our department can be responsible for such results.