Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Brighton and Sussex Medical School, Falmer, Brighton, UK.
Eye (Lond). 2021 Jul;35(7):1833-1849. doi: 10.1038/s41433-021-01463-8. Epub 2021 Mar 1.
Evaluation and recommendation of the scoring systems for technical skills (TS) and non-technical skills (NTS) assessments in ophthalmic surgery. A literature search was performed between December 2019 and May 2020. Studies describing the development or validation of TS or NTS scoring systems in ophthalmic surgery were included. Only scoring systems for completion by hand were included. The primary outcome was the validity and reliability status for each scoring system. The secondary outcome was recommendation based on modified Oxford Centre for Evidence-Based Medicine guidelines. Nineteen and five scoring systems were identified for TS and NTS respectively. TS scoring systems exist for cataract surgery (including the steps of phacoemulsification and paediatric cataract surgery) ptosis, strabismus, lateral tarsal strip, vitrectomy, and intraocular surgery in general. NTS scoring systems apply to cataract surgery or ophthalmic surgery in general. No single scoring system satisfied all validity and reliability measures. The recommended TS scoring systems are 'International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubrics' (ICO-OSCAR) for phacoemulsification, strabismus and paediatric cataract surgery, and 'Objective Structured Assessment of Cataract Surgical Skill' (OSACSS). Non-Technical Skills for Surgeons (NOTSS), Observational Teamwork Assessment for Surgery (OTAS) and Anaesthetists Non-Technical Skills (ANTS) are recommended for NTS. There is a paucity of NTS scoring systems. Further research is required to validate all scoring systems to consistent standards. Limitations of the assessment tools included infrequent quantification of face and content validity, and inconsistency in terminology and statistical methods between studies.
眼科手术中技术技能（TS）和非技术技能（NTS）评估的评分系统的评估和推荐。2019 年 12 月至 2020 年 5 月进行了文献检索。纳入了描述眼科手术中 TS 或 NTS 评分系统开发或验证的研究。仅包括手动评分系统。主要结果是每个评分系统的有效性和可靠性状况。次要结果是基于改良牛津循证医学中心指南的推荐。分别确定了 19 个和 5 个用于 TS 和 NTS 的评分系统。TS 评分系统适用于白内障手术（包括超声乳化和小儿白内障手术步骤）、上睑下垂、斜视、外侧睑板条、玻璃体切割术和一般眼内手术。NTS 评分系统适用于白内障手术或一般眼科手术。没有一个评分系统同时满足所有有效性和可靠性标准。推荐的 TS 评分系统包括白内障超声乳化、斜视和小儿白内障手术的“国际眼科理事会眼科手术能力评估量表”（ICO-OSCAR），以及“白内障手术技能客观结构化评估”（OSACSS）。推荐使用非技术技能评估量表（NOTSS）、手术观察团队评估（OTAS）和麻醉师非技术技能（ANTS）评估 NTS。NTS 评分系统很少。需要进一步研究以验证所有评分系统达到一致的标准。评估工具的局限性包括很少量化面部和内容有效性，以及研究之间术语和统计方法的不一致。
