Helge Garåsen The Trondheim Model - NSDM

there were eleven cases with zero and one in difference, and one with two and two with three
in difference. Disagreements were defined to exist between the panels when there were a low
or medium score on the VAS-scale. Panel (B) had the highest score in nearly all 25 cases.
Figure 2. The difference between the mean score of the quality of information about
medication, medical history and the benefit of hospital stay from Panel A and Panel B
according to the assessed quality.
3
2
1
Pa
nel
A - 0
Pa 0 1 2 3 4 5 6 7 8 9
nel
B
-1
Medication
Medical History
Benefit
-2
-3
-4
(Panel A + Panel B)/2
There were variations in the assessments of some factors especially on the need for care, ADL
and social network, between the panellists. These variations might constitute a major problem
when physicians only use clinical judgments when they make decisions about admissions to
and discharges from general hospital care as well as when deciding which patients need longterm
nursing-home care. This is also reflected in the results, as consensus as to the benefit of
hospitalisation was fair between the panels (Table 3) and varied from poor to good, within the
panels and the professions (Table 4). There was a much higher degree of consensus amongst
the specialists (κ=0.64) than the other professions. Disagreement as to the benefit of
treatment between the specialist and the general practitioner in one of the panels was
particularly large (κ= 0.04).
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