Concurrent validity of augmented reality metrics applied to the fundamentals of laparoscopic surgery (FLS)
Concurrent validity of augmented reality metrics applied to the fundamentals of laparoscopic surgery (FLS)
复制标题
DOI：
10.1007/s00464-007-9261-5
复制
发表时间：
2007-08-01
影响因子：
3.1
通讯作者：
Bowyer, M. W.
中科院分区：
文献类型：
--
作者：
Ritter, E. M.;Kindelan, T. W.;Bowyer, M. W.
目的：目前腹腔镜手术基础（FLS）项目的技能评估是劳动密集型的，每1-2名受试者需要一名监考员。ProMIS增强现实（AR）模拟器（Haptica, Dublin IR）允许通过仪器跟踪技术对物理任务进行客观评估。我们假设ProMIS指标可以在较少人员要求的情况下区分能力组和标准FLS评分。方法：我们招募了60名志愿者。受试者根据他们的腹腔镜手术经验分层。那些做过100次以上腹腔镜手术的人被认为是有经验的（n = 8）。那些少于10次腹腔镜手术的被认为是新手（n = 44）。其余为中间产物（n = 8）。所有受试者在ProMIS模拟器中进行了多达五次的FLS peg转移任务。为每个试验生成FLS评分、仪器路径长度和仪器平滑度评估。结果：在五项试验中，经验丰富的外科医生的表现优于中级外科医生，中级外科医生又优于新手。在所有试验中，FLS评分（p < 0.001）、ProMIS路径长度（p < 0.001）和ProMIS平滑度（p < 0.001）的组间差异均有统计学意义。当将FLS评分与路径长度和平滑度指标进行比较时，新手（r = 0.78, r = 0.94, p < 0.001）、中级（r = 0.5, p = 0.2, r 0.98, p < 0.001）和经验丰富的外科医生（r 0.86, p = 0.006, r = 0.99, p < 0.001）的评分之间存在明显的强相关性。结论：FLS钉转移任务的标准评分可以区分经验丰富、中级和新手外科医生。当使用ProMIS的度量来评估任务时，同样的构造是有效的。这些分数之间的高相关性建立了ProMIS指标的并发有效性。使用AR对FLS任务进行客观评估可以在保持客观性的同时减少评估这些技能的人员需求。
Objective: Current skills assessment in the Fundamentals of Laparoscopic Surgery (FLS) program is labor intensive, requiring one proctor for every 1-2 subjects. The ProMIS Augmented Reality (AR) simulator (Haptica, Dublin IR) allows for objective assessment of physical tasks through instrument tracking technology. We hypothesized that the ProMIS metrics could differentiate between ability groups as well as standard FLS scoring with fewer personnel requirementsMethods: We recruited 60 volunteer subjects. Subjects were stratified based on their laparoscopic surgical experience. Those who had performed more than 100 laparoscopic procedures were considered experienced (n = 8). Those with fewer than 10 laparoscopic procedures were considered novices (n = 44). The rest were intermediates (n = 8). All subjects performed up to five trials of the peg transfer task from FLS in the ProMIS simulator. The FLS score, instrument path length, and instrument smoothness assessment were generated for each trial.Results: For each of the five trials, experienced surgeons outperformed intermediates, who in turn outperformed novices. Statistically significant differences were seen between the groups across all trials for FLS score (p < 0.001), ProMIS path length (p < 0.001), and ProMIS smoothness (p < 0.001). When the FLS score was compared to the path length and smoothness metrics, a strong relationship between the scores was apparent for novices (r = 0.78, r = 0.94, p < 0.001) respectively), intermediates (r = 0.5, p = 0.2, r 0.98, p < 0.001), and experienced surgeons (r 0.86, p = 0.006, r = 0.99, p < 0.001).Conclusions: The construct that the standard scoring of the FLS peg transfer task can discriminate between experienced, intermediate, and novice surgeons is validated. The same construct is valid when the task is assessed using the metrics of the ProMIS. The high correlation between these scores establishes the concurrent validity of the ProMIS metrics. The use of AR for objective assessment of FLS tasks could reduce the personnel requirements of assessing these skills while maintaining the objectivity.