Wolfson Unit for Endoscopy, St. Mark's Hospital and Imperial College London HA1 3UJ., United Kingdom.
Gastrointest Endosc. 2011 Jun;73(6):1232-9.e2. doi: 10.1016/j.gie.2011.01.069.
Despite its ubiquitous use over the past 4 decades, there is no structured, formal method with which to assess polypectomy.
To develop and validate a new method with which to assess competency in polypectomy.
Polypectomy underwent task deconstruction, and a structured checklist and global assessment scale were developed (direct observation of polypectomy skills [DOPyS]). Sixty bowel cancer screening polypectomy videos were randomly chosen for analysis and were scored independently by 7 expert assessors by using DOPyS. Each parameter and the global rating were scored from 1 to 4 (scores ≥3 = competency). The scores were analyzed by using generalizability theory (G theory).
Multicenter.
Fifty-nine of the 60 videos were assessable and scored. The majority of the assessors agreed across the pass/fail divide for the global assessment scale in 58 of 59 (98%) polyps. For G-theory analysis, 47 of the 60 videos were analyzed. G-theory analysis suggested that DOPyS is a reliable assessment tool, provided that it is used by 2 assessors to score 5 polypectomy videos all performed by 1 endoscopist. DOPyS scores obtained in this format would reflect the endoscopist's competence.
Small sample and polyp size.
This study is the first attempt to develop and validate a tool designed specifically for the assessment of technical skills in performing polypectomy. G-theory analysis suggests that DOPyS could reliably reflect an endoscopist's competence in performing polypectomy provided a requisite number of assessors and cases were used.
尽管过去 40 年来广泛使用，但目前仍缺乏一种结构化、正式的方法来评估息肉切除术。
开发和验证一种新的方法来评估息肉切除术的能力。
对息肉切除术进行任务解构，并制定了结构化检查表和总体评估量表（直接观察息肉切除术技能[DOPyS]）。随机选择 60 个结直肠癌筛查息肉切除术视频进行分析，并由 7 名专家评估员使用 DOPyS 进行独立评分。每个参数和总体评分均评分为 1 到 4 分（得分≥3 表示有能力）。使用概化理论（G 理论）对评分进行分析。
多中心。
60 个视频中有 59 个可评估并评分。在 59 个息肉中的 58 个（98%）中，大多数评估员在通过/失败的全球评估量表上达成一致。对于 G 理论分析，对 60 个视频中的 47 个进行了分析。G 理论分析表明，DOPyS 是一种可靠的评估工具，前提是由 2 名评估员对 1 名内镜医生完成的 5 个息肉切除术视频进行评分。以这种格式获得的 DOPyS 评分将反映内镜医生的能力。
样本量小和息肉大小。
这项研究首次尝试开发和验证一种专门用于评估执行息肉切除术技术技能的工具。G 理论分析表明，只要使用足够数量的评估员和病例，DOPyS 就可以可靠地反映内镜医生执行息肉切除术的能力。
