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Measuring to Improve: Peer and Crowd-sourced Assessments of Technical Skill with Robot-assisted Radical Prostatectomy.

Identifieur interne : 000C11 ( Main/Exploration ); précédent : 000C10; suivant : 000C12

Measuring to Improve: Peer and Crowd-sourced Assessments of Technical Skill with Robot-assisted Radical Prostatectomy.

Auteurs : Khurshid R. Ghani [États-Unis] ; David C. Miller [États-Unis] ; Susan Linsell [États-Unis] ; Andrew Brachulis [États-Unis] ; Brian Lane [États-Unis] ; Richard Sarle [États-Unis] ; Deepansh Dalela [États-Unis] ; Mani Menon [États-Unis] ; Bryan Comstock [États-Unis] ; Thomas S. Lendvay [États-Unis] ; James Montie [États-Unis] ; James O. Peabody [États-Unis]

Source :

European urology [ 1873-7560 ] ; 2016.

RBID : pubmed:26755338

Descripteurs français

English descriptors

Abstract

UNLABELLED

Because surgical skill may be a key determinant of patient outcomes, there is growing interest in skill assessment. In the Michigan Urological Surgery Improvement Collaborative (MUSIC), we assessed whether peer and crowd-sourced (ie, layperson) video review of robot-assisted radical prostatectomy (RARP) could distinguish technical skill among practicing surgeons. A total of 76 video clips from 12 MUSIC surgeons consisted of one of four parts of RARP and underwent blinded review by MUSIC peer surgeons and prequalified crowd-sourced reviewers. Videos were rated for global skill (Global Evaluation Assessment of Robotic Skills) and procedure-specific skill (Robotic Anastomosis and Competency Evaluation). We fit linear mixed-effects models to estimate mean peer and crowd ratings for each video. Individual video ratings were aggregated to calculate surgeon skill scores. Peers (n=25) completed 351 video ratings over 15 d, whereas crowd-sourced reviewers (n=680) completed 2990 video ratings in 38 h. Surgeon global skill scores ranged from 15.8 to 21.7 (peer) and from 19.2 to 20.9 (crowd). Peer and crowd ratings demonstrated strong correlation for both global (r=0.78) and anastomosis (r=0.74) skills. The two groups consistently agreed on the rank order of lower scoring surgeons, suggesting a potential role for crowd-sourced methodology in the assessment of surgical performance. Lack of patient outcomes is a limitation and forms the basis of future study.

PATIENT SUMMARY

We demonstrated the large-scale feasibility of assessing the technical skill of robotic surgeons and found that online crowd-sourced reviewers agreed with experts on the rank order of surgeons with the lowest technical skill scores.

DOI: 10.1016/j.eururo.2015.11.028
PubMed: 26755338

Affiliations:

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<term>Crowdsourcing (standards)</term>
<term>Feasibility Studies (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Internet (MeSH)</term>
<term>Male (MeSH)</term>
<term>Motor Skills (MeSH)</term>
<term>Observer Variation (MeSH)</term>
<term>Peer Review, Health Care (standards)</term>
<term>Process Assessment, Health Care (standards)</term>
<term>Prostatectomy (adverse effects)</term>
<term>Prostatectomy (methods)</term>
<term>Prostatectomy (standards)</term>
<term>Quality Improvement (standards)</term>
<term>Quality Indicators, Health Care (standards)</term>
<term>Reproducibility of Results (MeSH)</term>
<term>Robotic Surgical Procedures (adverse effects)</term>
<term>Robotic Surgical Procedures (methods)</term>
<term>Robotic Surgical Procedures (standards)</term>
<term>Task Performance and Analysis (MeSH)</term>
<term>Treatment Outcome (MeSH)</term>
<term>Video Recording (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Amélioration de la qualité (normes)</term>
<term>Analyse et exécution des tâches (MeSH)</term>
<term>Aptitudes motrices (MeSH)</term>
<term>Biais de l'observateur (MeSH)</term>
<term>Compétence clinique (normes)</term>
<term>Enregistrement sur magnétoscope (MeSH)</term>
<term>Externalisation ouverte (normes)</term>
<term>Humains (MeSH)</term>
<term>Indicateurs qualité santé (normes)</term>
<term>Internet (MeSH)</term>
<term>Interventions chirurgicales robotisées (effets indésirables)</term>
<term>Interventions chirurgicales robotisées (méthodes)</term>
<term>Interventions chirurgicales robotisées (normes)</term>
<term>Mâle (MeSH)</term>
<term>Prostatectomie (effets indésirables)</term>
<term>Prostatectomie (méthodes)</term>
<term>Prostatectomie (normes)</term>
<term>Reproductibilité des résultats (MeSH)</term>
<term>Résultat thérapeutique (MeSH)</term>
<term>Études de faisabilité (MeSH)</term>
<term>Évaluation des pratiques médicales par des pairs (normes)</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Prostatectomy</term>
<term>Robotic Surgical Procedures</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Interventions chirurgicales robotisées</term>
<term>Prostatectomie</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Prostatectomy</term>
<term>Robotic Surgical Procedures</term>
</keywords>
<keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Interventions chirurgicales robotisées</term>
<term>Prostatectomie</term>
</keywords>
<keywords scheme="MESH" qualifier="normes" xml:lang="fr"><term>Amélioration de la qualité</term>
<term>Compétence clinique</term>
<term>Externalisation ouverte</term>
<term>Indicateurs qualité santé</term>
<term>Interventions chirurgicales robotisées</term>
<term>Prostatectomie</term>
<term>Évaluation des pratiques médicales par des pairs</term>
</keywords>
<keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Clinical Competence</term>
<term>Crowdsourcing</term>
<term>Peer Review, Health Care</term>
<term>Process Assessment, Health Care</term>
<term>Prostatectomy</term>
<term>Quality Improvement</term>
<term>Quality Indicators, Health Care</term>
<term>Robotic Surgical Procedures</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Feasibility Studies</term>
<term>Humans</term>
<term>Internet</term>
<term>Male</term>
<term>Motor Skills</term>
<term>Observer Variation</term>
<term>Reproducibility of Results</term>
<term>Task Performance and Analysis</term>
<term>Treatment Outcome</term>
<term>Video Recording</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Analyse et exécution des tâches</term>
<term>Aptitudes motrices</term>
<term>Biais de l'observateur</term>
<term>Enregistrement sur magnétoscope</term>
<term>Humains</term>
<term>Internet</term>
<term>Mâle</term>
<term>Reproductibilité des résultats</term>
<term>Résultat thérapeutique</term>
<term>Études de faisabilité</term>
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<front><div type="abstract" xml:lang="en"><p><b>UNLABELLED</b>
</p>
<p>Because surgical skill may be a key determinant of patient outcomes, there is growing interest in skill assessment. In the Michigan Urological Surgery Improvement Collaborative (MUSIC), we assessed whether peer and crowd-sourced (ie, layperson) video review of robot-assisted radical prostatectomy (RARP) could distinguish technical skill among practicing surgeons. A total of 76 video clips from 12 MUSIC surgeons consisted of one of four parts of RARP and underwent blinded review by MUSIC peer surgeons and prequalified crowd-sourced reviewers. Videos were rated for global skill (Global Evaluation Assessment of Robotic Skills) and procedure-specific skill (Robotic Anastomosis and Competency Evaluation). We fit linear mixed-effects models to estimate mean peer and crowd ratings for each video. Individual video ratings were aggregated to calculate surgeon skill scores. Peers (n=25) completed 351 video ratings over 15 d, whereas crowd-sourced reviewers (n=680) completed 2990 video ratings in 38 h. Surgeon global skill scores ranged from 15.8 to 21.7 (peer) and from 19.2 to 20.9 (crowd). Peer and crowd ratings demonstrated strong correlation for both global (r=0.78) and anastomosis (r=0.74) skills. The two groups consistently agreed on the rank order of lower scoring surgeons, suggesting a potential role for crowd-sourced methodology in the assessment of surgical performance. Lack of patient outcomes is a limitation and forms the basis of future study.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>PATIENT SUMMARY</b>
</p>
<p>We demonstrated the large-scale feasibility of assessing the technical skill of robotic surgeons and found that online crowd-sourced reviewers agreed with experts on the rank order of surgeons with the lowest technical skill scores.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26755338</PMID>
<DateCompleted><Year>2016</Year>
<Month>12</Month>
<Day>13</Day>
</DateCompleted>
<DateRevised><Year>2019</Year>
<Month>12</Month>
<Day>10</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1873-7560</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>69</Volume>
<Issue>4</Issue>
<PubDate><Year>2016</Year>
<Month>Apr</Month>
</PubDate>
</JournalIssue>
<Title>European urology</Title>
<ISOAbbreviation>Eur Urol</ISOAbbreviation>
</Journal>
<ArticleTitle>Measuring to Improve: Peer and Crowd-sourced Assessments of Technical Skill with Robot-assisted Radical Prostatectomy.</ArticleTitle>
<Pagination><MedlinePgn>547-550</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S0302-2838(15)01189-6</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.eururo.2015.11.028</ELocationID>
<Abstract><AbstractText Label="UNLABELLED">Because surgical skill may be a key determinant of patient outcomes, there is growing interest in skill assessment. In the Michigan Urological Surgery Improvement Collaborative (MUSIC), we assessed whether peer and crowd-sourced (ie, layperson) video review of robot-assisted radical prostatectomy (RARP) could distinguish technical skill among practicing surgeons. A total of 76 video clips from 12 MUSIC surgeons consisted of one of four parts of RARP and underwent blinded review by MUSIC peer surgeons and prequalified crowd-sourced reviewers. Videos were rated for global skill (Global Evaluation Assessment of Robotic Skills) and procedure-specific skill (Robotic Anastomosis and Competency Evaluation). We fit linear mixed-effects models to estimate mean peer and crowd ratings for each video. Individual video ratings were aggregated to calculate surgeon skill scores. Peers (n=25) completed 351 video ratings over 15 d, whereas crowd-sourced reviewers (n=680) completed 2990 video ratings in 38 h. Surgeon global skill scores ranged from 15.8 to 21.7 (peer) and from 19.2 to 20.9 (crowd). Peer and crowd ratings demonstrated strong correlation for both global (r=0.78) and anastomosis (r=0.74) skills. The two groups consistently agreed on the rank order of lower scoring surgeons, suggesting a potential role for crowd-sourced methodology in the assessment of surgical performance. Lack of patient outcomes is a limitation and forms the basis of future study.</AbstractText>
<AbstractText Label="PATIENT SUMMARY" NlmCategory="RESULTS">We demonstrated the large-scale feasibility of assessing the technical skill of robotic surgeons and found that online crowd-sourced reviewers agreed with experts on the rank order of surgeons with the lowest technical skill scores.</AbstractText>
<CopyrightInformation>Published by Elsevier B.V.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ghani</LastName>
<ForeName>Khurshid R</ForeName>
<Initials>KR</Initials>
<AffiliationInfo><Affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA. Electronic address: kghani@med.umich.edu.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Miller</LastName>
<ForeName>David C</ForeName>
<Initials>DC</Initials>
<AffiliationInfo><Affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Linsell</LastName>
<ForeName>Susan</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Brachulis</LastName>
<ForeName>Andrew</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lane</LastName>
<ForeName>Brian</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Department of Urology, Spectrum Health, Grand Rapids, MI, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sarle</LastName>
<ForeName>Richard</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Michigan Institute of Urology, Dearborn, MI, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dalela</LastName>
<ForeName>Deepansh</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Menon</LastName>
<ForeName>Mani</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Comstock</LastName>
<ForeName>Bryan</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Department of Biostatistics, University of Washington, Seattle, WA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lendvay</LastName>
<ForeName>Thomas S</ForeName>
<Initials>TS</Initials>
<AffiliationInfo><Affiliation>Department of Urology, University of Washington, Seattle, WA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Montie</LastName>
<ForeName>James</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Peabody</LastName>
<ForeName>James O</ForeName>
<Initials>JO</Initials>
<AffiliationInfo><Affiliation>Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><CollectiveName>Michigan Urological Surgery Improvement Collaborative</CollectiveName>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016422">Letter</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2016</Year>
<Month>01</Month>
<Day>02</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>Switzerland</Country>
<MedlineTA>Eur Urol</MedlineTA>
<NlmUniqueID>7512719</NlmUniqueID>
<ISSNLinking>0302-2838</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D002983" MajorTopicYN="N">Clinical Competence</DescriptorName>
<QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D063045" MajorTopicYN="N">Crowdsourcing</DescriptorName>
<QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005240" MajorTopicYN="N">Feasibility Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D020407" MajorTopicYN="N">Internet</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D009048" MajorTopicYN="N">Motor Skills</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015588" MajorTopicYN="N">Observer Variation</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018024" MajorTopicYN="N">Peer Review, Health Care</DescriptorName>
<QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017064" MajorTopicYN="N">Process Assessment, Health Care</DescriptorName>
<QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011468" MajorTopicYN="N">Prostatectomy</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName>
<QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D058996" MajorTopicYN="N">Quality Improvement</DescriptorName>
<QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019984" MajorTopicYN="N">Quality Indicators, Health Care</DescriptorName>
<QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015203" MajorTopicYN="N">Reproducibility of Results</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D065287" MajorTopicYN="N">Robotic Surgical Procedures</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName>
<QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D013647" MajorTopicYN="Y">Task Performance and Analysis</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014741" MajorTopicYN="N">Video Recording</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Crowd sourcing</Keyword>
<Keyword MajorTopicYN="N">Radical prostatectomy</Keyword>
<Keyword MajorTopicYN="N">Robotic surgery</Keyword>
<Keyword MajorTopicYN="N">Skills assessment</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year>
<Month>09</Month>
<Day>09</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2015</Year>
<Month>11</Month>
<Day>23</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2016</Year>
<Month>1</Month>
<Day>13</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2016</Year>
<Month>1</Month>
<Day>13</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2016</Year>
<Month>12</Month>
<Day>15</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">26755338</ArticleId>
<ArticleId IdType="pii">S0302-2838(15)01189-6</ArticleId>
<ArticleId IdType="doi">10.1016/j.eururo.2015.11.028</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Michigan</li>
<li>Washington (État)</li>
</region>
<settlement><li>Seattle</li>
</settlement>
<orgName><li>Université de Washington</li>
</orgName>
</list>
<tree><country name="États-Unis"><region name="Michigan"><name sortKey="Ghani, Khurshid R" sort="Ghani, Khurshid R" uniqKey="Ghani K" first="Khurshid R" last="Ghani">Khurshid R. Ghani</name>
</region>
<name sortKey="Brachulis, Andrew" sort="Brachulis, Andrew" uniqKey="Brachulis A" first="Andrew" last="Brachulis">Andrew Brachulis</name>
<name sortKey="Comstock, Bryan" sort="Comstock, Bryan" uniqKey="Comstock B" first="Bryan" last="Comstock">Bryan Comstock</name>
<name sortKey="Dalela, Deepansh" sort="Dalela, Deepansh" uniqKey="Dalela D" first="Deepansh" last="Dalela">Deepansh Dalela</name>
<name sortKey="Lane, Brian" sort="Lane, Brian" uniqKey="Lane B" first="Brian" last="Lane">Brian Lane</name>
<name sortKey="Lendvay, Thomas S" sort="Lendvay, Thomas S" uniqKey="Lendvay T" first="Thomas S" last="Lendvay">Thomas S. Lendvay</name>
<name sortKey="Linsell, Susan" sort="Linsell, Susan" uniqKey="Linsell S" first="Susan" last="Linsell">Susan Linsell</name>
<name sortKey="Menon, Mani" sort="Menon, Mani" uniqKey="Menon M" first="Mani" last="Menon">Mani Menon</name>
<name sortKey="Miller, David C" sort="Miller, David C" uniqKey="Miller D" first="David C" last="Miller">David C. Miller</name>
<name sortKey="Montie, James" sort="Montie, James" uniqKey="Montie J" first="James" last="Montie">James Montie</name>
<name sortKey="Peabody, James O" sort="Peabody, James O" uniqKey="Peabody J" first="James O" last="Peabody">James O. Peabody</name>
<name sortKey="Sarle, Richard" sort="Sarle, Richard" uniqKey="Sarle R" first="Richard" last="Sarle">Richard Sarle</name>
</country>
</tree>
</affiliations>
</record>

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Measuring to Improve: Peer and Crowd-sourced Assessments of Technical Skill with Robot-assisted Radical Prostatectomy.

Measuring to Improve: Peer and Crowd-sourced Assessments of Technical Skill with Robot-assisted Radical Prostatectomy.

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