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评估关节镜肩袖修复技能的评分指标:新手和专家外科医生的绩效比较研究。

Scoring metrics for assessing skills in arthroscopic rotator cuff repair: performance comparison study of novice and expert surgeons.

机构信息

Computer Science Department, Florida Polytechnic University, 4700 Research Way, Lakeland, FL, 33805, USA.

Computer Science Department, University of Central Arkansas, Conway, AR, USA.

出版信息

Int J Comput Assist Radiol Surg. 2022 Oct;17(10):1823-1835. doi: 10.1007/s11548-022-02683-3. Epub 2022 Jun 7.


DOI:10.1007/s11548-022-02683-3
PMID:35672594
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9769496/
Abstract

PURPOSE: We aim to develop quantitative performance metrics and a deep learning model to objectively assess surgery skills between the novice and the expert surgeons for arthroscopic rotator cuff surgery. These proposed metrics can be used to give the surgeon an objective and a quantitative self-assessment platform. METHODS: Ten shoulder arthroscopic rotator cuff surgeries were performed by two novices, and fourteen were performed by two expert surgeons. These surgeries were statistically analyzed. Two existing evaluation systems: Basic Arthroscopic Knee Skill Scoring System (BAKSSS) and the Arthroscopic Surgical Skill Evaluation Tool (ASSET), were used to validate our proposed metrics. In addition, a deep learning-based model called Automated Arthroscopic Video Evaluation Tool (AAVET) was developed toward automating quantitative assessments. RESULTS: The results revealed that novice surgeons used surgical tools approximately 10% less effectively and identified and stopped bleeding less swiftly. Our results showed a notable difference in the performance score between the experts and novices, and our metrics successfully identified these at the task level. Moreover, the F1-scores of each class are found as 78%, 87%, and 77% for classifying cases with no-tool, electrocautery, and shaver tool, respectively. CONCLUSION: We have constructed quantitative metrics that identified differences in the performances of expert and novice surgeons. Our ultimate goal is to validate metrics further and incorporate these into our virtual rotator cuff surgery simulator (ViRCAST), which has been under development. The initial results from AAVET show that the capability of the toolbox can be extended to create a fully automated performance evaluation platform.

摘要

目的:我们旨在开发定量绩效指标和深度学习模型,以客观评估关节镜肩袖手术中新手和专家外科医生的手术技能。这些拟议的指标可用于为外科医生提供客观和定量的自我评估平台。

方法:由两位新手完成十次肩关节关节镜肩袖手术,由两位专家完成十四次手术。对这些手术进行了统计分析。使用了两种现有的评估系统:基础关节镜膝关节技能评分系统(BAKSSS)和关节镜手术技能评估工具(ASSET)来验证我们提出的指标。此外,还开发了一种名为自动化关节镜视频评估工具(AAVET)的基于深度学习的模型,以实现定量评估的自动化。

结果:结果表明,新手外科医生使用手术工具的效率约低 10%,识别和停止出血的速度也较慢。我们的结果显示,专家和新手之间的绩效评分存在显著差异,我们的指标在任务级别成功地识别了这些差异。此外,对无工具、电烙术和修剪器工具分类的每个类别的 F1 分数分别为 78%、87%和 77%。

结论:我们构建了定量指标,以识别专家和新手外科医生之间的表现差异。我们的最终目标是进一步验证指标并将其纳入我们正在开发的虚拟肩袖手术模拟器(ViRCAST)中。AAVET 的初步结果表明,该工具包的功能可以扩展到创建一个完全自动化的性能评估平台。

相似文献

[1]
Scoring metrics for assessing skills in arthroscopic rotator cuff repair: performance comparison study of novice and expert surgeons.

Int J Comput Assist Radiol Surg. 2022-10

[2]
Arthroscopic Rotator Cuff Repair Metrics: Establishing Face, Content, and Construct Validity in a Cadaveric Model.

Arthroscopy. 2020-1

[3]
A hierarchical task analysis of shoulder arthroscopy for a virtual arthroscopic tear diagnosis and evaluation platform (VATDEP).

Int J Med Robot. 2017-9

[4]
Outcomes of single-row and double-row arthroscopic rotator cuff repair: a systematic review.

J Bone Joint Surg Am. 2010-3

[5]
Shoulder outcome scoring systems have substantial ceiling effects 2 years after arthroscopic rotator cuff repair.

Knee Surg Sports Traumatol Arthrosc. 2021-7

[6]
One-year Patient-reported Outcomes After Arthroscopic Rotator Cuff Repair Do Not Correlate With Mild to Moderate Psychological Distress.

Clin Orthop Relat Res. 2015-11

[7]
Arthroscopic versus Mini-Open Rotator Cuff Repair: Should We Ignore the Mini-Open Surgery?

Acta Chir Orthop Traumatol Cech. 2021

[8]
Training resources in arthroscopic rotator cuff repair.

J Bone Joint Surg Am. 2007-6

[9]
Anchorless Arthroscopic Transosseous and Anchored Arthroscopic Transosseous Equivalent Rotator Cuff Repair Show No Differences in Structural Integrity or Patient-reported Outcomes in a Matched Cohort.

Clin Orthop Relat Res. 2020-6

[10]
Comparison of Structural Integrity and Functional Outcome Between Delaminated and Nondelaminated Rotator Cuff Tears After En Masse Arthroscopic Repair: A Retrospective Cohort Study With Propensity Score Matching.

Am J Sports Med. 2019-5

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Use of artificial intelligence in the analysis of digital videos of invasive surgical procedures: scoping review.

BJS Open. 2025-7-1

[2]
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Comput Graph. 2024-4

[3]
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[4]
Validity of a virtual reality-based straight coloanal anastomosis simulator.

Int J Comput Assist Radiol Surg. 2025-3

[5]
Automated analysis of operative video in surgical training: scoping review.

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[6]
Validity Evidence for Procedure-specific Competence Assessment Tools in Orthopaedic Surgery: A Scoping Review.

J Am Acad Orthop Surg Glob Res Rev. 2024-1-1

本文引用的文献

[1]
Movement-level process modeling of microsurgical bimanual and unimanual tasks.

Int J Comput Assist Radiol Surg. 2022-2

[2]
Trends Associated with Open Versus Arthroscopic Rotator Cuff Repair.

HSS J. 2019-7

[3]
A hierarchical task analysis of shoulder arthroscopy for a virtual arthroscopic tear diagnosis and evaluation platform (VATDEP).

Int J Med Robot. 2017-9

[4]
Assessing Performance in Shoulder Arthroscopy: The Imperial Global Arthroscopy Rating Scale (IGARS).

J Bone Joint Surg Am. 2014-7-2

[5]
The Arthroscopic Surgical Skill Evaluation Tool (ASSET).

Am J Sports Med. 2013-4-2

[6]
Is there a valid and reliable assessment of diagnostic knee arthroscopy skill?

Clin Orthop Relat Res. 2012-12-20

[7]
3D convolutional neural networks for human action recognition.

IEEE Trans Pattern Anal Mach Intell. 2013-1

[8]
Effect of the ACGME duty hours restrictions on surgical residents and faculty: a systematic review.

Acad Med. 2011-1

[9]
The development of an objective model to assess arthroscopic performance.

J Bone Joint Surg Am. 2009-9

[10]
Shoulder arthroscopy positioning: lateral decubitus versus beach chair.

Arthroscopy. 2009-8

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