Ready for OR or not? Human reader supplements Eyesi scoring in cataract surgical skills assessment

Madeleine Selvander,1,2 Peter Åsman11Department of Clinical Sciences, Malmö: Ophthalmology, Lund University, Malmö, Sweden; 2Practicum Clinical Skills Centre, Skåne University Hospital, Malmö, SwedenPurpose: To compare the internal computer-based scorin...

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Autores principales:	Selvander M, &Aring;sman P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/5e6efae05b424ea89ad2231c52dee398
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spelling	oai:doaj.org-article:5e6efae05b424ea89ad2231c52dee3982021-12-02T01:55:19ZReady for OR or not? Human reader supplements Eyesi scoring in cataract surgical skills assessment1177-54671177-5483https://doaj.org/article/5e6efae05b424ea89ad2231c52dee3982013-10-01T00:00:00Zhttp://www.dovepress.com/ready-for-or-or-not-human-reader-supplements-eyesi-scoring-in-cataract-a14562https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Madeleine Selvander,1,2 Peter Åsman11Department of Clinical Sciences, Malmö: Ophthalmology, Lund University, Malmö, Sweden; 2Practicum Clinical Skills Centre, Skåne University Hospital, Malmö, SwedenPurpose: To compare the internal computer-based scoring with human-based video scoring of cataract modules in the Eyesi virtual reality intraocular surgical simulator, a comparative case series was conducted at the Department of Clinical Sciences – Ophthalmology, Lund University, Skåne University Hospital, Malmö, Sweden.Methods: Seven cataract surgeons and 17 medical students performed one video-recorded trial with each of the capsulorhexis, hydromaneuvers, and phacoemulsification divide-and-conquer modules. For each module, the simulator calculated an overall score for the performance ranging from 0 to 100. Two experienced masked cataract surgeons analyzed each video using the Objective Structured Assessment of Cataract Surgical Skill (OSACSS) for individual models and modified Objective Structured Assessment of Surgical Skills (OSATS) for all three modules together. The average of the two assessors' scores for each tool was used as the video-based performance score. The ability to discriminate surgeons from naive individuals using the simulator score and the video score, respectively, was compared using receiver operating characteristic (ROC) curves.Results: The ROC areas for simulator score did not differ from 0.5 (random) for hydromaneuvers and phacoemulsification modules, yielding unacceptably poor discrimination. OSACSS video scores all showed good ROC areas significantly different from 0.5. The OSACSS video score was also superior compared to the simulator score for the phacoemulsification procedure: ROC area 0.945 vs 0.664 for simulator score (P = 0.010). Corresponding values for capsulorhexis were 0.887 vs 0.761 (P = 0.056) and for hydromaneuvers 0.817 vs 0.571 (P = 0.052) for the video scores and simulator scores, respectively.The ROC area for the combined procedure was 0.938 for OSATS video score and 0.799 for simulator score (P=0.072).Conclusion: Video-based scoring of the phacoemulsification procedure was superior to the innate simulator scoring system in distinguishing cataract surgical skills. Simulator scoring rendered unacceptably poor discrimination for both the hydromaneuvers and the phacoemulsification divide-and-conquer module. Our results indicate a potential for improvement in Eyesi internal computer-based scoring.Keywords: simulator, training, cataract surgery, ROC, virtual realitySelvander M&Aring;sman PDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 1973-1977 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Selvander M &Aring;sman P Ready for OR or not? Human reader supplements Eyesi scoring in cataract surgical skills assessment
description	Madeleine Selvander,1,2 Peter Åsman11Department of Clinical Sciences, Malmö: Ophthalmology, Lund University, Malmö, Sweden; 2Practicum Clinical Skills Centre, Skåne University Hospital, Malmö, SwedenPurpose: To compare the internal computer-based scoring with human-based video scoring of cataract modules in the Eyesi virtual reality intraocular surgical simulator, a comparative case series was conducted at the Department of Clinical Sciences – Ophthalmology, Lund University, Skåne University Hospital, Malmö, Sweden.Methods: Seven cataract surgeons and 17 medical students performed one video-recorded trial with each of the capsulorhexis, hydromaneuvers, and phacoemulsification divide-and-conquer modules. For each module, the simulator calculated an overall score for the performance ranging from 0 to 100. Two experienced masked cataract surgeons analyzed each video using the Objective Structured Assessment of Cataract Surgical Skill (OSACSS) for individual models and modified Objective Structured Assessment of Surgical Skills (OSATS) for all three modules together. The average of the two assessors' scores for each tool was used as the video-based performance score. The ability to discriminate surgeons from naive individuals using the simulator score and the video score, respectively, was compared using receiver operating characteristic (ROC) curves.Results: The ROC areas for simulator score did not differ from 0.5 (random) for hydromaneuvers and phacoemulsification modules, yielding unacceptably poor discrimination. OSACSS video scores all showed good ROC areas significantly different from 0.5. The OSACSS video score was also superior compared to the simulator score for the phacoemulsification procedure: ROC area 0.945 vs 0.664 for simulator score (P = 0.010). Corresponding values for capsulorhexis were 0.887 vs 0.761 (P = 0.056) and for hydromaneuvers 0.817 vs 0.571 (P = 0.052) for the video scores and simulator scores, respectively.The ROC area for the combined procedure was 0.938 for OSATS video score and 0.799 for simulator score (P=0.072).Conclusion: Video-based scoring of the phacoemulsification procedure was superior to the innate simulator scoring system in distinguishing cataract surgical skills. Simulator scoring rendered unacceptably poor discrimination for both the hydromaneuvers and the phacoemulsification divide-and-conquer module. Our results indicate a potential for improvement in Eyesi internal computer-based scoring.Keywords: simulator, training, cataract surgery, ROC, virtual reality
format	article
author	Selvander M &Aring;sman P
author_facet	Selvander M &Aring;sman P
author_sort	Selvander M
title	Ready for OR or not? Human reader supplements Eyesi scoring in cataract surgical skills assessment
title_short	Ready for OR or not? Human reader supplements Eyesi scoring in cataract surgical skills assessment
title_full	Ready for OR or not? Human reader supplements Eyesi scoring in cataract surgical skills assessment
title_fullStr	Ready for OR or not? Human reader supplements Eyesi scoring in cataract surgical skills assessment
title_full_unstemmed	Ready for OR or not? Human reader supplements Eyesi scoring in cataract surgical skills assessment
title_sort	ready for or or not? human reader supplements eyesi scoring in cataract surgical skills assessment
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/5e6efae05b424ea89ad2231c52dee398
work_keys_str_mv	AT selvanderm readyfororornothumanreadersupplementseyesiscoringincataractsurgicalskillsassessment AT amparingsmanp readyfororornothumanreadersupplementseyesiscoringincataractsurgicalskillsassessment
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Ready for OR or not? Human reader supplements Eyesi scoring in cataract surgical skills assessment

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