一个基于视频的特定程序能力评估工具,用于最小侵入性食道切除术
Mirte H M Ketel1, Bastiaan R Klarenbeek1, Yassin Eddahchouri1
1Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
JAMA surgery
|December 27, 2023
概括
开发和验证了一种用于最小侵入性食道切除术 (MIE) 的新能力评估工具 (CAT). 这种MIE-CAT工具对评估MIE手术中的外科表现非常有希望,有助于培训和研究.
科学领域:
- 外科教育的外科教育
- 医疗器械开发 医疗器械开发
- 提高外科手术的质量
背景情况:
- 最少侵入性食道切除术 (MIE) 是一种复杂的手术程序,具有的学习曲线.
- 在复杂的微创手术中,低于最佳的外科手术性能与较差的患者结果有关.
研究的目的:
- 开发和验证一种程序特定的能力评估工具 (CAT),用于微创食管切除术 (MIE).
主要方法:
- 一项国际质量改进研究开发并验证了MIE-CAT,其中包括8个程序阶段和4个质量组件,在利克特级别上得分.
- 18名国际MIE专家对32个手术内MIE视频进行了同行评审,以评估可行性,有效性和可靠性.
- 改进了MIE-CAT版本2以提高分层间的可靠性.
主要成果:
- 专家们发现MIE-CAT是可行的,易于使用的,表现出良好的内部可靠性 (ICCs 0.807-0.898).
- 间隔剂可靠性中度 (ICCs 0.536-0.705),差异主要在淋巴切除术阶段.
- 构造有效性得到了MIE-CAT得分与手术经验,血液损失,手术时间和并发症率之间的相关性支持.
结论:
- 开发的MIE-CAT是可行的,并且已被验证用于评估MIE手术性能.
- MIE-CAT为临床实践,外科培训和MIE研究提供了宝贵的见解.
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