Raza Syed Johar, Field Erinn, Jay Christopher, Eun Daniel, Fumo Michael, Hu Jim C, Lee David, Mehboob Zayn, Nyquist John, Peabody James O, Sarle Richard, Stricker Hans, Yang Zhengyu, Wilding Gregory, Mohler James L, Guru Khurshid A
Department of Urology, Roswell Park Cancer Institute, Buffalo, NY.
Department of Urology, Temple University School of Medicine, Philadelphia, PA.
Urology. 2015 Jan;85(1):27-32. doi: 10.1016/j.urology.2014.09.017.
To develop and validate an assessment tool for the performance of urethrovesical anastomosis (UVA).
A multicenter, prospective, observational study was conducted in 2 phases. Phase 1, development and content validation, used a panel of 5 experienced robotic surgeons to develop a 6-domain scoring system, Robotic Anastomosis Competence Evaluation (RACE), to assess technical skills for performing UVA. Phase 2, construct validation and reliability, used 5 blinded experienced robotic surgeons to rate UVA recordings of expert, advanced beginner, and novice groups. Content validation index was determined to report consensus in phase 1. Phase 2 involved comparison of RACE scores among the 3 groups. Wilcoxon rank-sum tests were used to compare RACE scores.
Two rounds of Delphi methodology achieved consensus on language and content of RACE. Eight experts, 10 advanced beginners, and 10 novice robotic surgeons participated in the validation study. The overall score for the expert group (27.3) was higher than that of the advanced beginner (19.5; P = .04) and novice groups (13.6; P = .001). The advanced beginner and novice groups differed in overall scores (P = .03).
RACE allows evaluation of surgical competence to perform UVA for robot-assisted radical prostatectomy, when using an inanimate model.
开发并验证一种用于评估尿道膀胱吻合术（UVA）操作的评估工具。
进行了一项多中心、前瞻性观察性研究，分为两个阶段。第一阶段，开发与内容验证，由5名经验丰富的机器人外科医生组成的小组开发了一个6领域评分系统，即机器人吻合术能力评估（RACE），以评估进行UVA的技术技能。第二阶段，结构验证与可靠性验证，由5名不知情的经验丰富的机器人外科医生对专家组、高级初学者组和新手组的UVA操作记录进行评分。确定内容验证指数以报告第一阶段的共识。第二阶段涉及比较三组之间的RACE评分。使用Wilcoxon秩和检验比较RACE评分。
两轮德尔菲法在RACE的语言和内容上达成了共识。8名专家、10名高级初学者和10名新手机器人外科医生参与了验证研究。专家组的总体得分（27.3）高于高级初学者组（19.5；P = .04）和新手组（13.6；P = .001）。高级初学者组和新手组的总体得分存在差异（P = .03）。
当使用无生命模型时，RACE可用于评估机器人辅助根治性前列腺切除术中进行UVA的手术能力。
