International Journal of Technology Assessment in Health Care

General Essays

Assessing the Predictive Validity of the RAND/UCLA Appropriateness Method Criteria for Performing Carotid Endarterectomy

Paul G. Shekellea1, Mark R. Chassina2 and R. E. Parka3

a1 West Los Angeles Veterans Affairs Medical Center and The RAND Corporation

a2 Mount Sinai Medical Center

a3 The RAND Corporation


We assessed the predictive validity of an expert panel's ratings of the appropriateness of carotid endarterectomy by comparing ratings to the results of subsequent randomized clinical trials. We found the trials confirmed the ratings for 44 indications (covering almost 30% of operations performed in 1981) and refuted the ratings for none.