Department of Thoracic and Vascular Surgery, Ghent University Hospital, 2K12D, Route 1024, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Department of Vascular Surgery, University Hospital Centre of Nantes, Nantes, France.
Cardiovasc Intervent Radiol. 2020 Sep;43(9):1331-1341. doi: 10.1007/s00270-020-02590-7. Epub 2020 Jul 19.
Radiation safety performance is often evaluated using dose parameters measured by personal dosimeters and/or the C-arm, which provide limited information about teams' actual radiation safety behaviors. This study aimed to develop a rating scale to evaluate team radiation safety behaviors more accurately and investigate its reliability.
A modified Delphi consensus was organized involving European vascular surgeons (VS), interventional radiologists, and interventional cardiologists. Initial items and anchors were drafted a priori and rated using five-point Likert scales. Participants could suggest additional items or adjustments. Consensus was defined as ≥ 80% agreement (rating ≥ 4) with Cronbach's alpha ≥ .80. Two VS with expertise in radiation safety evaluated 15 video-recorded endovascular repairs of infrarenal aortic aneurysms (EVAR) to assess usability, inter and intrarater reliability.
Thirty-one of 46 invited specialists completed three rating rounds to generate the final rating scale. Five items underwent major adjustments. In the final round, consensus was achieved for all items (alpha = .804; agreement > 87%): 'Pre-procedural planning', 'Preparation in angiosuite/operating room', 'Shielding equipment', 'Personal protective equipment', 'Position of operator/team', 'Radiation usage awareness', 'C-arm handling', 'Adjusting image quality', 'Additional dose reducing functions', 'Communication/leadership', and 'Overall radiation performance and ALARA principle'. All EVARs were rated, yielding excellent Cronbach's alpha (.877) with acceptable interrater and excellent intrarater reliability (ICC = .782; ICC = .963, respectively).
A reliable framework was developed to assess radiation safety behaviors in endovascular practice and provide teams with formative feedback. The final scale is provided in this publication.
辐射安全性能通常通过个人剂量计和/或 C 臂测量的剂量参数进行评估，这些参数提供了有关团队实际辐射安全行为的有限信息。本研究旨在开发一种更准确评估团队辐射安全行为的评分量表，并研究其可靠性。
采用改良 Delphi 共识法，邀请欧洲血管外科医生（VS）、介入放射学家和介入心脏病学家参与。预先起草初始项目和锚定，并使用 5 分李克特量表进行评分。参与者可以提出其他项目或调整建议。共识定义为≥80%（评分≥4）的一致意见，Cronbach's α≥0.80。两位具有辐射安全专业知识的 VS 评估了 15 例腹主动脉瘤腔内修复术（EVAR）的视频记录，以评估可用性、组内和组间可靠性。
46 名受邀专家中有 31 名完成了三轮评分，生成了最终的评分量表。有 5 个项目进行了重大调整。在最后一轮，所有项目均达成共识（α=0.804；一致性>87%）：“术前规划”、“血管套房/手术室准备”、“屏蔽设备”、“个人防护设备”、“术者/团队位置”、“辐射使用意识”、“C 臂操作”、“调整图像质量”、“额外的剂量降低功能”、“沟通/领导力”和“整体辐射性能和辐射防护最优化原则”。对所有 EVAR 进行了评分，得出了优秀的 Cronbach's α（0.877），具有可接受的组内和优秀的组间可靠性（ICC=0.782；ICC=0.963）。
开发了一种可靠的框架来评估血管腔内实践中的辐射安全行为，并为团队提供形成性反馈。最终的量表在本出版物中提供。
