Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, Canada.
Equipe MediCIS, Faculté de Médicine, Université de Rennes 1, Rennes, France.
Int J Comput Assist Radiol Surg. 2018 Jul;13(7):1129-1139. doi: 10.1007/s11548-018-1753-3. Epub 2018 Apr 4.
Deep brain stimulation (DBS) is an increasingly common treatment for neurodegenerative diseases. Neurosurgeons must have thorough procedural, anatomical, and functional knowledge to plan electrode trajectories and thus ensure treatment efficacy and patient safety. Developing this knowledge requires extensive training. We propose a training approach with objective assessment of neurosurgeon proficiency in DBS planning.
To assess proficiency, we propose analyzing both the viability of the planned trajectory and the manner in which the operator arrived at the trajectory. To improve understanding, we suggest a self-guided training course for DBS planning using real-time feedback. To validate the proposed measures of proficiency and training course, two experts and six novices followed the training course, and we monitored their proficiency measures throughout.
At baseline, experts planned higher quality trajectories and did so more efficiently. As novices progressed through the training course, their proficiency measures increased significantly, trending toward expert measures.
We developed and validated measures which reliably discriminate proficiency levels. These measures are integrated into a training course, which quantitatively improves trainee performance. The proposed training course can be used to improve trainees' proficiency, and the quantitative measures allow trainees' progress to be monitored.
深部脑刺激（DBS）是治疗神经退行性疾病的一种越来越常见的方法。神经外科医生必须具备全面的程序、解剖和功能知识，以规划电极轨迹，从而确保治疗效果和患者安全。发展这些知识需要广泛的培训。我们提出了一种具有客观评估神经外科医生 DBS 规划能力的培训方法。
为了评估能力，我们建议分析计划轨迹的可行性以及操作员到达轨迹的方式。为了提高理解，我们建议使用实时反馈来进行 DBS 规划的自我指导培训课程。为了验证所提出的能力和培训课程的措施，两名专家和六名新手参加了培训课程，我们在整个过程中监测了他们的能力措施。
在基线时，专家规划了更高质量的轨迹，并且效率更高。随着新手在培训课程中的进展，他们的能力措施显著增加，趋向于专家措施。
我们开发并验证了可靠区分能力水平的措施。这些措施被整合到一个培训课程中，可以定量提高学员的表现。所提出的培训课程可以用来提高学员的能力，并且定量措施可以监测学员的进展。
