Tremblay Catherine, Grantcharov Teodor, Urquia Marcelo L, Satkunaratnam Abheha
Département d'obstétrique-gynécologie, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal QC.
Department of Surgery, University of Toronto, Toronto ON; Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto ON.
J Obstet Gynaecol Can. 2014 Nov;36(11):1014-1023. doi: 10.1016/S1701-2163(15)30416-3.
To achieve consensus among experts on the essentials steps to include in an assessment tool for total laparoscopic hysterectomy.
Using a Delphi consensus process, an initial survey was created based on the current literature and local expertise in laparoscopic surgery and sent to international experts in laparoscopic gynaecology. Experts were selected according to specific criteria. A second survey was formulated based on the answers and comments from the first round and sent to all experts who participated in the first round. Consensus was defined as a Cronbach alpha ≥ 0.80. A rate of agreement ≥ 0.70 was used to define which substeps to keep in the final tool.
From the 85 experts invited to participate, 53 (62%) agreed to participate, and 51 of these participated in both rounds. The final instrument to assess total laparoscopic hysterectomy was created using the items with a high level of agreement after two rounds. This final tool showed good internal consistency among the experts, with a Cronbach alpha of 0.90.
Using a Delphi methodology, we achieved international consensus among experts in laparoscopic gynaecology within a short time frame and with minimal costs. The resulting evaluation tool for total laparoscopic hysterectomy may serve in the assessment of surgical skills in the future, and would be a valuable adjunct to postgraduate training and continuing medical education programs. This tool will now undergo a validation process, comparing the rating scores of novices and experts surgeons.
就全腹腔镜子宫切除术评估工具应包含的基本步骤达成专家共识。
采用德尔菲共识法,基于当前文献以及腹腔镜手术的本地专业知识创建初始调查问卷,并发送给国际腹腔镜妇科专家。专家根据特定标准选定。根据第一轮的答案和评论制定第二轮调查问卷,并发送给所有参与第一轮的专家。共识定义为克朗巴哈系数α≥0.80。使用≥0.70的一致率来确定最终工具中保留哪些子步骤。
在受邀参与的85位专家中,53位(62%)同意参与,其中51位参与了两轮调查。经过两轮调查后,使用达成高度一致的项目创建了评估全腹腔镜子宫切除术的最终工具。该最终工具在专家中显示出良好的内部一致性,克朗巴哈系数α为0.90。
通过德尔菲方法,我们在短时间内以最低成本达成了腹腔镜妇科专家的国际共识。所得的全腹腔镜子宫切除术评估工具未来可用于评估手术技能,并且将成为研究生培训和继续医学教育项目的宝贵辅助工具。该工具现在将进行验证过程,比较新手外科医生和专家外科医生的评分。