Compares the development of appropriateness criteria for upper gastrointestinal endoscopy in the United States and in Switzerland. It concludes that separate expert panels in different countries, using a standardized methodology, produce similar criteria for appropriateness of medical procedures, and indicated that given the resources being invested throughout the world in developing criteria and guidelines, international collaboration for seeking optimal use of limited health care resources should be intensified. In particular, 78% of compatible indications were assigned to identical categories of appropriateness by both the U.S. and Swiss panels, which produced a kappa of 0.76--a high level of agreement between the Swiss and American panels--demonstrating that such indications can be used across countries to measure appropriateness of medical care.
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