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During the period March-May 2013, two observers (senior internal medicine residents with at least 4-years' training in general internal medicine wards and QDU) independently reviewed all medical records to assess individual appropriateness of each referral.
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These teams can also help instigate discussion regarding goals of care for individual patients, including appropriateness (or not) of ICU admission and end-of-life decision-making [ 26, 27].
According to the logic of appropriateness, individuals consider their situation, evaluate their role in that situation, weigh actions according to their appropriateness, and finally do what is appropriate.
The appropriateness of individual, more intimate, and small-scaled interiors is more subtle.
In these audits, appropriateness of individual elective CS is discussed within the medical team.
Another issue that has been raised in regard to the HADS is the appropriateness of individual items with specific patient groups [ 17].
In contrast, implicit criteria of PIMs are statements that are used to evaluate the appropriateness of individual drugs prescribed for older patients.
Assessment tools are being used increasingly for the evaluation of prescribing quality in older people, but their application cannot substitute the individual assessment of prescribing appropriateness [ 16].
Subsequently, both translations were assessed by a panel of ten competent referees for the form and content of individual statements and for appropriateness and clarity of the questionnaire's instructions.
The MAI was developed in 1992 [ 30] to determine the drug's appropriateness for individual patients on 10 items and is proven to be reliable [ 31] and applicable in the Dutch nursing home setting [ 32].
Four factors were identified for the present study as having an important influence on the effect of curative interventions: efficacy of individual drugs, diagnostic accuracy, appropriateness of the treatment prescribed and patient compliance.
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