Centre for Clinical Education, University of Copenhagen and Capital Region of Denmark, Denmark.
Eur J Vasc Endovasc Surg. 2011 Oct;42(4):539-48. doi: 10.1016/j.ejvs.2011.05.003. Epub 2011 Jun 15.
To study the construct validity and reliability of a novel endovascular global rating scale, Structured Assessment of endoVascular Expertise (SAVE).
A Clinical, experimental study.
Twenty physicians with endovascular experiences ranging from complete novices to highly experienced operators performed a video-recorded simulated contra-lateral iliac-artery-stenting procedure. The virtual-patient case was a novel technically challenging procedure presenting the distal arteries below the knee.
Three experts assessed the performances blinded to operator identity. Validity was analysed by correlating experience with performance results. Reliability was analysed according to generalisability theory.
The mean score on the 29 items of the SAVE scale correlated well with clinical experience (R = 0.84, P < 0.01) and was found discriminative even among the more experienced participants having performed up to 500 endovascular procedures in total. Only the most experienced participants (>5000 procedures) obtained maximum scores. The inter-rater reliability was high (G = 0.94 and G = 0.95). The procedure time (median 69 min, range 32-86) correlated moderately with clinical experience (R = -0.53, P < 0.05), whereas the fluoroscopy time and amount of contrast fluid did not correlate.
The construct validity and reliability of assessment with the SAVE scale was high when applied to performances in a simulation setting with advanced realism. No ceiling effect was present in the assessment situation.
研究一种新型腔内整体评分量表——结构性腔内专家技能评估（SAVE）的构建效度和信度。
临床、实验研究。
20 名具有从完全新手到经验丰富操作者不同程度腔内经验的医生进行了一项视频记录的模拟对侧髂动脉支架置入术。虚拟患者病例为一种新颖的技术挑战性手术，涉及到膝盖以下的远端动脉。
三位专家在不了解操作者身份的情况下对表现进行盲评。通过将经验与表现结果相关联来分析有效性。根据概化理论分析可靠性。
SAVE 量表 29 个项目的平均得分与临床经验高度相关（R = 0.84，P < 0.01），即使在总共进行了多达 500 次腔内手术的经验更丰富的参与者中，也具有区分能力。只有最有经验的参与者（>5000 例手术）才能获得最高分。评分者间信度很高（G = 0.94 和 G = 0.95）。手术时间（中位数 69 分钟，范围 32-86 分钟）与临床经验中度相关（R = -0.53，P < 0.05），而透视时间和造影剂用量与临床经验无相关性。
当应用于具有高度逼真度的模拟环境中的表现评估时，SAVE 量表的构建效度和信度均较高。评估情况不存在天花板效应。
