Department of Computer Science, Florida Polytechnic University, 4700 Research Way, Lakeland, FL, 33805, USA.
Department of Computer Science, University of Central Arkansas, Conway, USA.
Surg Endosc. 2022 Jul;36(7):5167-5182. doi: 10.1007/s00464-021-08893-1. Epub 2021 Nov 29.
Endoscopic sleeve gastroplasty (ESG) is a minimally invasive endoscopic weight loss procedure used to treat obesity. The long-term goal of this project is to develop a Virtual Bariatric Endoscopy (ViBE) simulator for training and assessment of the ESG procedure. The objectives of this current work are to: (a) perform a task analysis of ESG and (b) create metrics to be validated in the created simulator.
We performed a hierarchical task analysis (HTA) by identifying the significant tasks of the ESG procedure. We created the HTA to show the breakdown and connection of the tasks of the procedure. Utilizing the HTA and input from ESG experts, performance metrics were derived for objective measurement of the ESG procedure. Three blinded video raters analyzed seven recorded ESG procedures according to the proposed performance metrics.
Based on the seven videos, there was a positive correlation between total task times and total performance scores (R = 0.886, P = 0.008). Endoscopists expert were found to be more skilled in reducing the area of the stomach compared to endoscopists novice (34.6% reduction versus 9.4% reduction, P = 0.01). The mean novice performance score was significantly lower than the mean expert performance score (34.7 vs. 23.8, P = 0.047). The inter-rater reliability test showed a perfect agreement among three raters for all tasks except for the suturing task. The suturing task had a significant agreement (Inter-rater Correlation = 0.84, Cronbach's alpha = 0.88). Suturing was determined to be a critical task that is positively correlated with the total score (R = 0.962, P = 0.0005).
The task analysis and metrics development are critical for the development of the ViBE simulator. This preliminary assessment demonstrates that the performance metrics provide an accurate assessment of the endoscopist's performance. Further validation testing and refinement of the performance metrics are anticipated.
内镜袖状胃切除术（ESG）是一种用于治疗肥胖症的微创内镜减重程序。该项目的长期目标是开发一种虚拟减重内镜（ViBE）模拟器，用于培训和评估 ESG 程序。本研究的目的是：（a）对 ESG 进行任务分析；（b）创建要在创建的模拟器中验证的指标。
我们通过识别 ESG 程序的重要任务进行了层次任务分析（HTA）。我们创建 HTA 以显示程序任务的细分和连接。利用 HTA 和 ESG 专家的输入，得出了用于客观测量 ESG 程序的绩效指标。三名盲审视频评分员根据提出的绩效指标分析了七段记录的 ESG 程序。
基于七段视频，总任务时间与总绩效评分之间存在正相关关系（R=0.886，P=0.008）。与新手内镜医生相比，专家内镜医生在减少胃面积方面的技能更熟练（减少 34.6% 与减少 9.4%，P=0.01）。新手的平均绩效评分明显低于专家的平均绩效评分（34.7 与 23.8，P=0.047）。组内相关系数测试显示，对于所有任务（缝合任务除外），三名评分员之间的一致性很高。缝合任务的一致性非常高（组内相关系数=0.84，Cronbach 的 alpha=0.88）。缝合被确定为与总分呈正相关的关键任务（R=0.962，P=0.0005）。
任务分析和指标开发对于 ViBE 模拟器的开发至关重要。本初步评估表明，绩效指标可准确评估内镜医生的表现。预计将进一步验证测试和完善绩效指标。
