Consistency Across Panels of Ratings of Appropriateness of Dental Care Treatment Procedures

This article reports on a study investigating the consistency across different consensus panels of ratings of appropriateness for dental procedures. The study conducted four consensus panels to determine, under various conditions, the appropriateness of five options for patients: no treatment; filling; crown; root canal with a filling or crown; extraction. The patients were categorized according to age; regular versus irregular use of dental care; degree of caries; degree of pain; degree of periodontal disease. The panelists were dentists enrolled in a continuing education program on assessing the quality of dental care. The panelists were all individuals employed by various dental plans to evaluate the quality of care plans operating in California. The results indicate that the method does distinguish the dimensions of appropriateness used by the panelists in making their decisions, and that it is possible to substantially increase consensus among a diverse group of dentists and across separate panels on some procedures. However, it also showed that the process is sensitive to varying panels and that different variables had different outcomes in the ratings from the various panels. The consensus panel method holds some promise for determining the appropriateness of dental care. However, the results of this study question whether it results in consistent ratings across different panels.