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Questions and Answers

JAMA. 1991;265(24):3321-3323. doi:10.1001/jama.1991.03460240119048.
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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 is appropriate for the given indication in the specified patient population; 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 is inappropriate for the given indication in the specified patient population; 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 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 concept "appropriate" includes the categories "promising" and "established," while the concept "inappropriate" includes the categories "doubtful" and "unacceptable." 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. P values for the survey responses are as follows: question A, 19 "appropriate" responses out of 23, P =.0013 consensus for appropriate; question B, 21 "appropriate" responses out of 23, P<.0001, consensus for appropriate. Eleven panelists offered no opinion for questions A and B.
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