Development and validation of surgical training tool: cystectomy assessment and surgical evaluation (CASE) for robot-assisted radical cystectomy for men.
Development and validation of surgical training tool: cystectomy assessment and surgical evaluation (CASE) for robot-assisted radical cystectomy for men.
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手术培训工具的开发和验证：男性机器人辅助根治性膀胱切除术的膀胱切除术评估和手术评估（CASE）。
DOI：
10.1007/s00464-018-6191-3
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Guru,KhurshidA
中科院分区：
文献类型：
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作者：
Hussein,AhmedA;Sexton,KevinJ;May,PaulR;Meng,MaxwellV;Hosseini,Abolfazl;Eun,DanielD;Daneshmand,Siamak;Bochner,BernardH;Peabody,JamesO;Abaza,Ronney;Skinner,EilaC;Hautmann,RichardE;Guru,KhurshidA
BackgroundWe旨在开发一个结构化的评分工具：cyberspace评估和手术评估（CASE），客观的措施和量化的性能在机器人辅助根治cyberspace（RARC）为man.MethodsA多国10外科医生专家小组合作对开发和验证的CASE。男性RARC的关键步骤被解构为9个关键领域，每个领域由5个锚点进行评估。利用德尔菲方法进行内容验证。对每个锚的背景、评分一致性和清晰度进行评估。计算每个方面的内容效度指数（CVI）。CVI ≥ 0.75代表共识，该声明从下一轮中删除。重复这一过程，直到所有发言都达成协商一致意见。CASE被用来评估去识别视频的RARC，以确定可靠性和结构效度。线性加权百分比一致性用于评估评估者间可靠性（IRR）。一个logit模型的比值比（OR）被用来评估结构validation.ResultsThe专家小组达成共识后，四个回合的情况下。CASE的最后8个领域包括：盆腔淋巴结清扫、输尿管周围间隙的发育、盆腔外侧间隙、直肠前间隙、血管蒂的控制、膀胱前间隙、背侧静脉复合体的控制和心尖清扫。所有8个领域的IRR均> 0.6。专家优于学员在所有domain.ConclusionWe开发和验证了一个可靠的结构化，程序的具体工具，在RARC手术性能的客观评价。CASE可以帮助区分新手和专家的表现。
BackgroundWe aimed to develop a structured scoring tool: cystectomy assessment and surgical evaluation (CASE) that objectively measures and quantifies performance during robot-assisted radical cystectomy (RARC) for men.MethodsA multinational 10-surgeon expert panel collaborated towards development and validation of CASE. The critical steps of RARC in men were deconstructed into nine key domains, each assessed by five anchors. Content validation was done utilizing the Delphi methodology. Each anchor was assessed in terms of context, score concordance, and clarity. The content validity index (CVI) was calculated for each aspect. A CVI ≥ 0.75 represented consensus, and this statement was removed from the next round. This process was repeated until consensus was achieved for all statements. CASE was used to assess de-identified videos of RARC to determine reliability and construct validity. Linearly weighted percent agreement was used to assess inter-rater reliability (IRR). A logit model for odds ratio (OR) was used to assess construct validation.ResultsThe expert panel reached consensus on CASE after four rounds. The final eight domains of the CASE included: pelvic lymph node dissection, development of the peri-ureteral space, lateral pelvic space, anterior rectal space, control of the vascular pedicle, anterior vesical space, control of the dorsal venous complex, and apical dissection. IRR > 0.6 was achieved for all eight domains. Experts outperformed trainees across all domains.ConclusionWe developed and validated a reliable structured, procedure-specific tool for objective evaluation of surgical performance during RARC. CASE may help differentiate novice from expert performances.