Methods of assessment of the level of surgeons for minimally invasive fixation of distal radius fractures: 'expertise' versus 'performance'

Autor: François Ducournau, Laela El Amiri, Paul Vernet, Marie-Cécile Sapa, Philippe Liverneaux
Rok vydání: 2022
Předmět:
Zdroj: International Orthopaedics. 47:193-199
ISSN: 1432-5195
0341-2695
DOI: 10.1007/s00264-022-05609-5
Popis: The results of surgical techniques vary depending on the level of the surgeon's experience. The level of expertise can be evaluated quantitatively or qualitatively. In this study, we evaluated the duration of the procedure and the size of the incision of minimally invasive fixation of distal radius fractures as a means of grading expertise and surgical performance. The null hypothesis of our study was that the level of expertise did not match the level of performance.The study included 52 surgeons split in five levels of expertise who had performed 467 minimally invasive fixations of distal radius fractures. The performance of the surgeons in terms of duration of the procedure and size of the incision were scored according to the five levels of surgical experience using four different methodologies: clinical (setting limits compared to data found in literature), statistical (setting statistical limits of comparison in percentiles (20th, 40th, 60th, 80th) for each of the two parameters measured), arithmetical (setting limits compared to equal intervals for each of the 2 variables), and success rate (setting a threshold for each of the 2 variables).Our results showed a great disparity between levels of experience depending on the method used. The scores for levels 1 and 2 were 72% for expertise, 13% for performance according to the clinical method, 75% for the statistical method, 0% for the arithmetical method, and 57% according the success rate. The rate of level 3 was 23% for expertise, 41% for performance by the clinical method, 17% by the statistical method, 17% by the arithmetical method, and 15% by the success rate. The rates of levels 4 and 5 were 5% for expertise, 46% for performance clinical method, 8% by the statistical method, 83% by the arithmetical method, and 28% by the success rate.The null hypothesis of our study was confirmed by the results which show that there was no correlation between levels of expertise and performance. The clinical method of assessment appears to reflect best the true level of performance of the surgeon.Publications reporting the results of a surgical technique for a given pathology should always mention the level of performance as measured on a clinical scale.
Databáze: OpenAIRE
Externí odkaz: