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JAMA. 1991;265(12):1585-1587. doi:10.1001/jama.1991.03460120099045.
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"Safe" and "effective" are defined as follows: Safety is the condition of presenting a reasonably low risk of harm, injury, or loss when a technology is utilized in the specified indication; and effectiveness is the quality of producing a desired, beneficial effect under the conditions of actual use.
The categories for response to a DATTA question are defined as follows: Established—this technology has been adequately evaluated and its (A) safety or (B) effectiveness is accepted as appropriate by the practicing medical community for the given indication in the specified patient population; Promising—given current knowledge, the (A) safety or (B) effectiveness of this technology appears to be appropriate for the given indication in the specified patient population; as more experience and long-term follow-up are accumulated, this interim rating will change; Investigational— there is no consensus on the (A) safety or (B) effectiveness of this technology to date, there is insufficient evidence to determine its appropriateness, or it warrants further study; use of this technology for the given indication in the specified patient population should be confined largely to research protocols; Doubtful—given current knowledge, the (A) safety or (B) effectiveness of this technology appears to be inappropriate for the given indication in the specified patient population; as more experience and long-term follow-up are accumulated, this interim rating will change; and Unacceptable—the (A) safety or (B) effectiveness of this technology is regarded by the practicing medical community as inappropriate for the given indication in the specified patient population.
For each question, any response category receiving 50% or more of the panel's votes was tested for a consensus by assuming that the DATTA panel is a sample from a broader population of experts. Using exact binomial probabilities, the likelihood of the observed vote was calculated if exactly 50% of the total population of experts support that response for that question. Hence, the null hypothesis is that 50% of all experts support the response, and the alternative, one-tailed hypothesis is that more than 50% of all experts support the response. Rejection of the null hypothesis, and acceptance of the alternative, is interpreted as evidence of a majority opinion in the total population of experts, and a consensus is achieved. If no consensus was found, the categories were reorganized and reanalyzed. The definitions of "promising" and "established" include the concept of "appropriate," while the "doubtful" and "unacceptable" definitions include the concept of "inappropriate." The original five categories were thus, if necessary, reorganized into three categories, "appropriate," "investigational," and "inappropriate"; an analysis of any category with 50% or more of the vote was performed.
The P values for the survey responses are as follows: question A, 31 "appropriate" responses out of 40, P =.0003, consensus for appropriate; question B, 34 "appropriate" responses out of 40, P<.0001, consensus for appropriate. There were nine panelists who offered no opinion for questions A and B.
The Role of Laparoscopic Cholecystectomy: Guidelines for Clinical Application . Los Angeles, Calif: Society of American Gastrointestinal Endoscopic Surgeons; 1990.
Reddick EJ, Olsen DO.  Laparoscopic laser cholecystectomy: a comparison with mini-lap cholecystectomy . Surg Endosc. 1989;3:131-133.
Link to Article[[XSLOpenURL/10.1007/BF00591357]]
Dubois F, Icard P, Berthelot G, Levard H.  Celioscopic cholecystectomy: preliminary report of 36 cases . Ann Surg. 1990;211:60-62.
Link to Article[[XSLOpenURL/10.1097/00000658-199001000-00010]]
Berci G, Sackier J, Paz-Partlow M.  Laparoscopic cholecystectomy, miniaccess surgery: reality or utopia? Postgrad Gen Surg. 1990;2:50-54.
Granting of Privileges for Laparoscopic (Peritoneoscopic) General Surgery . Los Angeles, Calif: Society of American Gastrointestinal Endoscopic Surgeons; 1990.
 Experts opine . Surv Anesthesiol. 1986;30:306-308.

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