Velocity-Domain Motion Quality Measures for Surgical Performance Evaluation and Feedback
Velocity-Domain Motion Quality Measures for Surgical Performance Evaluation and Feedback
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DOI：
10.1115/1.4049310
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发表时间：
2021-03-01
影响因子：
0.9
通讯作者：
O'Malley, Marcia K.
中科院分区：
文献类型：
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作者：
Murali, Barathwaj;Belvroy, Viony M.;O'Malley, Marcia K.
血管内导航熟练程度需要外科医生具有大量的手动灵活性。源自血管内工具尖端运动学的客观性能测量已被证明与专业知识相关；然而，这些指标尚未在培训期间用作实时绩效反馈的基础。本文评估了一组源自导丝运动的基于速度的性能测量，以确定它们是否适合在线性能评估和反馈。我们使用三个指标（光谱弧长、平均速度和空闲时间）评估了 75 名参与者的血管内导航技能，因为他们使用虚拟现实模拟器将工具引导至解剖目标。首先，我们检查了导航任务和经验水平对性能的影响，发现新手的性能与中级和专家的性能显着不同。然后，我们计算了在线计算的测量值与离线计算的光谱弧长（我们的“黄金标准”指标）之间的相关性（在试验结束时，使用整个试验的数据）。我们的结果表明，在线计算的平均速度和空闲时间与离线计算的谱弧长有很强且一致的相关性，但在比较在线和离线计算的谱弧长时，情况并非如此。因此，平均速度和空闲时间这两种基于时域的性能度量比频谱弧长（一种基于频域的度量）更适合用作在线性能反馈的基础。未来的工作需要确定如何根据这些指标最好地向血管内手术学员提供实时表现反馈。
Endovascular navigation proficiency requires a significant amount of manual dexterity from surgeons. Objective performance measures derived from endovascular tool tip kinematics have been shown to correlate with expertise; however, such metrics have not yet been used during training as a basis for real-time performance feedback. This paper evaluates a set of velocity-based performance measures derived from guidewire motion to determine their suitability for online performance evaluation and feedback. We evaluated the endovascular navigation skill of 75 participants using three metrics (spectral arc length, average velocity, and idle time) as they steered tools to anatomical targets using a virtual reality simulator. First, we examined the effect of navigation task and experience level on performance and found that novice performance was significantly different from intermediate and expert performance. Then we computed correlations between measures calculated online and spectral arc length, our "gold standard" metric, calculated offline (at the end of the trial, using data from the entire trial). Our results suggest that average velocity and idle time calculated online are strongly and consistently correlated with spectral arc length computed offline, which was not the case when comparing spectral arc length computed online and offline. Average velocity and idle time, both time-domain based performance measures, are therefore more suitable measures than spectral arc length, a frequency-domain based metric, to use as the basis of online performance feedback. Future work is needed to determine how to best provide real-time performance feedback to endovascular surgery trainees based on these metrics.