Berger P, Willems M C M, Van Der Vliet J A, Schultze Kool L J, Bergqvist D, Blankensteijn J D
Department of Surgery, Division of Vascular Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
J Cardiovasc Surg (Torino). 2010 Apr;51(2):253-6.
Endovascular skills are an integral part of modern-day vascular surgery. The STRESS machine has been developed to test these skills in vascular surgeons. This study aims to define an optimal pass/fail cutoff value for the STRESS test score.
The STRESS machine consists of a dry glass model of the abdominal aorta and its tributaries with various stenotic lesions, elongations, and tortuosities. A camera and computer software are used to simulate plain fluoroscopy-mode. The test subjects are given two assignments after which two reviewers use a combination of the ICEPS and MRS to produce the final total score; 43 subjects were tested. According to previous endovascular experience, subjects were classified into four groups: novice-low (no experience, less than 11 performed procedures, less than 50 assisted procedures), novice-high (11-25 performed procedures, more than 50 assisted procedures), intermediate (1-10 performed and >11-25 assisted procedures, 11-25 performed and >1-10 assisted procedures or 25-50 performed procedures) and advanced (more than 50 performed procedures).
Test-score and noted experience showed a correlation of 0.794. All intermediate and advanced test subjects scored more than 50 points compared to 4 out of 15 novices.
We demonstrated that it is possible to determine an optimal cut-off value for competence testing with the STRESS machine.
血管腔内技术是现代血管外科不可或缺的一部分。STRESS机器已被开发用于测试血管外科医生的这些技能。本研究旨在确定STRESS测试分数的最佳通过/失败临界值。
STRESS机器由腹主动脉及其分支的干玻璃模型组成，带有各种狭窄病变、伸长和扭曲。使用摄像头和计算机软件模拟普通荧光透视模式。给测试对象两项任务，之后两名评审员使用ICEPS和MRS的组合得出最终总分；对43名受试者进行了测试。根据以往的血管腔内经验，受试者被分为四组：新手低水平组（无经验，进行少于11例手术，辅助手术少于50例）、新手高水平组（进行11 - 25例手术，辅助手术多于50例）、中级组（进行1 - 10例手术且辅助手术>11 - 25例，或进行11 - 25例手术且辅助手术>1 - 10例，或进行25 - 50例手术）和高级组（进行多于50例手术）。
测试分数与经验显示出0.794的相关性。所有中级和高级测试对象得分超过50分，相比之下，15名新手中有4人得分超过50分。
我们证明了使用STRESS机器确定能力测试的最佳临界值是可行的。
