Artificial Intelligence Driven Tools for Objective Surgical Performance Improvement

摘要/概要 目前，监督手术培训只提供了一个执业职业生涯中的一小部分手术经验， 外科医生外科医生的技能在他们的职业生涯中不断发展。外科医生受益于专家的监督反馈， 但是一旦他们开始独立练习，他们就失去了这种结构化和具体的反馈。手术技巧是 与患者结局相关。因此，通过自动化技术支持外科医生的持续专业学习， 结构化资源可以改善患者护理。外科医生在实践中的现状是测量患者的结果， 其他护理过程变量作为其技能的间接测量。这些措施并没有告知外科医生如何改进。 这个项目的目标是开发工具来分析外科手术领域的视频，为外科医生提供公正的技能 评估和具体反馈如何改进。该项目包括将这些工具集成到个性化的 外科学习平台及其对外科医生技能获取的有效性评价。为了实现这一目标，该项目 包括一个多学科的团队，包括眼科，外科教育，外科数据科学，计算机 视觉、机器学习和深度学习、统计和人机交互。开发的视频分析工具 白内障手术是美国最常见的外科手术之一， 在世界各地：1）客观评估外科医生的技能; 2）为外科医生提供关于如何改进的具体反馈 这是个性化的考虑到他们过去的表现;和3）个性化学习的有效性的初步证据 外科医生技能获取的平台。我们的工作的预期影响是创造一种途径， 激励他们将自己及其表现视为改善护理结果和价值的过程的一部分， 医疗机构可以使用客观的工具来制定可复制的外科能力标准。

Abstract / Summary Currently, supervised surgical training provides only a small fraction of surgical experience in the career of a practicing surgeon. Surgeons’ skill develops throughout their career. Surgeons benefit from supervised feedback from experts during training, but they lose such structured and specific feedback once they begin independent practice. Surgical skill is associated with patient outcomes. Therefore, supporting surgeons’ continuous professional learning through automated structured resources can improve patient care. The status quo for surgeons in practice is to measure patient outcomes or other process of care variables as indirect measures of their skill. These measures do not inform surgeons how to improve. The goal in this project is to develop tools to analyze videos of the surgical field to provide surgeons with unbiased skill assessments and specific feedback on how to improve. This project includes integration of these tools into a personalized surgical learning platform and evaluation of its effectiveness for surgeons’ skill acquisition. To achieve this goal, this project includes a multi-disciplinary team to include expertise in ophthalmology, surgical education, surgical data science, computer vision, machine learning and deep learning, statistics, and human-computer interaction. The video analysis tools developed in this project will enable the following for cataract surgery, one of the most common surgical procedures in the U.S. and across the world: 1) objective assessments of surgeons’ skill; 2) provide surgeons with specific feedback on how to improve that is personalized given their past performance; and 3) preliminary evidence of effectiveness of a personalized learning platform for surgeons’ skill acquisition. The anticipated impact of our work is to create a pathway in which the surgeon is incentivized to see themselves and their performance as part of the process of improving outcomes and value in care, and institutions have access to objective tools to create reproducible standards for surgical competency.