WCWL - General Surgery

The WCWL general surgery panel developed and tested a set of standardized clinical criteria for setting priorities among patients awaiting elective general surgery of all kinds. The criteria were applied to 561 patients in 3 western provinces. Regression analysis was used to determine the set of criteria weights that collectively best predicted clinicians' overall urgency ratings. The priority criteria accounted for almost two-thirds of the observed variance in clinicians' urgency ratings (adjusted R2 = 64.1%) for a mixed group of patients. The panel modified the criteria and weights based on empiric findings and clinical judgment. Inter-rater and test-retest reliability of criteria items appeared to be good based on clinicians' ratings of 6 videotaped, standardized patient interviews. The panel considered the criteria easy to use and reasonably reflective of expert surgical judgment regarding clinical urgency.