An objective and automated method for assessing surgical skill in endoscopic sinus surgery using eye-tracking and tool-motion data
An objective and automated method for assessing surgical skill in endoscopic sinus surgery using eye-tracking and tool-motion data
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DOI：
10.1002/alr.21053
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发表时间：
2012-11-01
影响因子：
6.4
通讯作者：
Hager, Gregory D.
中科院分区：
文献类型：
--
作者：
Ahmidi, Narges;Ishii, Masaru;Hager, Gregory D.
背景资料：手术技能评估在确定能力、监测教育计划和提供受训者反馈方面起着至关重要的作用。随着医疗保健环境的变化，它可能会在认证和维护认证方面发挥重要作用。理想的技能评估工具应该是公正、客观和准确的。我们假设工具运动数据外科医生如何移动他/她的仪器和眼睛凝视数据外科医生在他/她操作时看什么包含足够的信息来定量和客观地评估手术技巧。我们通过建立一个手术统计模型，并在鼻内窥镜手术（ESS）的背景下对该模型进行实验性检验来研究这一假设。方法：7名专家和13名新手外科医生共记录了378次试验，同时他们执行了一系列9种不同的ESS任务。使用电磁跟踪器收集数据，以记录外科医生的工具和内窥镜运动。此外，使用红外眼动仪摄像机记录外科医生眼睛注视的位置。将这些数据拟合到统计模型中，并用于测试技能评估的准确性。结果：专家外科医生的技能被正确识别为94.6%的任务。对于新手外科医生进行的手术，所提出的模型正确地认识到技能水平与88.6%的准确率。结论：我们提出了一个客观和公正的方法来评估内窥镜鼻窦外科医生的技能。实验结果表明，该方法成功地识别专家和新手外科医生的技能水平。
Background: Assessment of surgical skill plays a crucial role in determining competency, monitoring educational programs, and providing trainee feedback. With the changing health care environment, it will likely play an important role in credentialing and maintenance of certification. The ideal skill assessment tool should be unbiased, objective, and accurate. We hypothesize that tool-motion datahow a surgeon moves his/her instrumentsand eye-gaze datawhat a surgeon looks at when he/she operatescontain sufficient information to quantitatively and objectively evaluate surgical skill. We investigate this hypothesis by developing a statistical model of surgery and testing the model experimentally in the context of endoscopic sinus surgery (ESS). Methods: A total of 378 trials were recorded from 7 expert and 13 novice surgeons while they were performing a series of 9 different ESS tasks. Data was collected using an electromagnetic tracker to record the surgeon's tool and endoscope motions. In addition, the location of surgeon's eye gaze was recorded using an infrared eye tracker camera. This data was fit to the statistical model and used to test the accuracy of skill assessment. Results: The skill of expert surgeons was identified correctly for 94.6% of tasks. For surgeries performed by novice surgeons the proposed model properly recognizes the skill level with 88.6% accuracy. Conclusion: We present an objective and unbiased method for assessing the skill of endoscopic sinus surgeons. Experimental results show that the proposed method successfully identifies the skill levels of both expert and novice surgeons.