Development and Validation of an Objective Scoring Tool to Evaluate Surgical Dissection : Dissection Assessment for Robotic Technique (DART)

Autor: Thomas S. Lendvay, Erik Vanstrum, Xiaomeng Lei, Jessica H. Nguyen, Jim C. Hu, Runzhuo Ma, Justin W. Collins, Rene Sotelo, Alireza Ghoreifi, Alvin Goh, Roger Gerjy, Wesley Yip, Michael Chevinksy, Mihir M. Desai, Jullet Han, Monish Aron, Chandru P. Sundaram, Siamak Daneshmand, Steven Cen, Ryan P. Powers, Jacqueline Maya-Silva, Andrew J. Hung, James Porter, Michael Zhang, Inderbir S. Gill, Daniel I. Sanford, Rainer Kimmig, John W. Davis, Charles F. Polotti
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Urol Pract
Popis: Introduction: Evaluation of surgical competency has important implications for training new surgeons, accreditation, and improving patient outcomes. A method to specifically evaluate dissection performance does not yet exist. This project aimed to design a tool to assess surgical dissection quality. Methods: Delphi method was used to validate structure and content of the dissection evaluation. A multi-institutional and multi-disciplinary panel of 14 expert surgeons systematically evaluated each element of the dissection tool. Ten blinded reviewers evaluated 46 de-identified videos of pelvic lymph node and seminal vesicle dissections during the robot-assisted radical prostatectomy. Inter-rater variability was calculated using prevalence-adjusted and bias-adjusted kappa. The area under the curve from receiver operating characteristic curve was used to assess discrimination power for overall Dissection Assessment for Robotic Technique (DART) scores as well as domains in discriminating trainees (100). Results: Four rounds of Delphi method achieved language and content validity in 27/28 elements. Use of 3 or 5-point scale remained contested; thus, both scales were evaluated during validation. The 3-point scale showed improved kappa for each domain. Experts demonstrated significantly greater total scores on both scales (3-point, p
Databáze: OpenAIRE