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人工智能算法发展的初步阶段:100 位外科医生在桡骨远端骨折内固定手术视频的相位标注中的差异。

Preliminary stage in the development of an artificial intelligence algorithm: Variations between 100 surgeons in phase annotation in a video of internal fixation of distal radius fracture.

机构信息

ICube CNRS UMR7357, Strasbourg University, 2-4, rue Boussingault, 67000 Strasbourg, France; IHU, Institute of image-guided surgery, Strasbourg, France.

Department of hand surgery, Strasbourg University Hospitals, FMTS, 1, avenue Molière, 67200 Strasbourg, France.

出版信息

Orthop Traumatol Surg Res. 2023 Oct;109(6):103564. doi: 10.1016/j.otsr.2023.103564. Epub 2023 Jan 24.


DOI:10.1016/j.otsr.2023.103564
PMID:36702298
Abstract

INTRODUCTION: In order to be used naturally and widely, an artificial intelligence algorithm of phase detection in surgical videos presupposes an expert consensus defining phases. OBJECTIVES: The aim of the present study was to seek consensus in defining the various phases of a surgical technique in wrist traumatology. METHODS: Three thousand two hundred and twenty-nine surgeons were sent a video showing anterior plate fixation of the distal radius and a questionnaire on the number of phases they distinguished and the visual cues signaling the beginning of each phase. Three experimenters predefined the number of phases (5: installation, approach, fixation, verification, closure) and sub-phases (3a: introduction of plate; 3b: positioning distal screws; 3c: positioning proximal screws) and the cues signaling the beginning of each. The numbers of the responses per item were collected. RESULTS: Only 216 (6.7%) surgeons opened the questionnaire, and 100 answered all questions (3.1%). Most respondents claimed 5/5 expertise. Number of phases identified ranged between 3 and 10. More than two-thirds of respondents identified the same phase cue as defined by the 3 experimenters in most cases, except for "verification" and "positioning proximal screws". DISCUSSION: Surgical procedures comprise a succession of phases, the beginning or end of which can be defined by a precise visual cue on video, either beginning with the appearance of the cue or the disappearance of the cue defining the preceding phase. CONCLUSION: These cues need to be defined very precisely before attempting manual annotation of surgical videos in order to develop an artificial intelligence algorithm. LEVEL OF EVIDENCE: II.

摘要

简介:为了实现自然和广泛的应用,手术视频中的相位检测人工智能算法需要专家共识来定义相位。 目的:本研究旨在寻求在腕关节创伤学中定义手术技术各阶段的共识。 方法:向 3229 名外科医生发送了一段展示桡骨远端前路钢板固定的视频和一份问卷,询问他们区分的阶段数以及每个阶段开始的视觉提示。三位实验者预先定义了阶段数(5 个:安装、入路、固定、验证、关闭)和亚阶段(3a:引入钢板;3b:定位远端螺钉;3c:定位近端螺钉)以及每个阶段开始的提示。收集每个项目的响应数量。 结果:只有 216 名(6.7%)外科医生打开了问卷,100 名(3.1%)回答了所有问题。大多数受访者声称有 5/5 专业知识。识别的阶段数在 3 到 10 之间。超过三分之二的受访者在大多数情况下识别出与三位实验者定义的相同的阶段提示,除了“验证”和“定位近端螺钉”。 讨论:手术过程包括一系列阶段,其开始或结束可以通过视频上的精确视觉提示来定义,要么从提示出现开始,要么从定义前一阶段的提示消失开始。 结论:在尝试手动注释手术视频以开发人工智能算法之前,这些提示需要非常精确地定义。 证据水平:II 级。

相似文献

[1]
Preliminary stage in the development of an artificial intelligence algorithm: Variations between 100 surgeons in phase annotation in a video of internal fixation of distal radius fracture.

Orthop Traumatol Surg Res. 2023-10

[2]
Distal radius fixation through a mini-invasive approach of 15 mm. PART 1: a series of 144 cases.

Eur J Orthop Surg Traumatol. 2014-8

[3]
How Many Screws Are Needed for Reliable Stability of Extra-articular Nonosteoporotic Distal Radius Fractures Fixed with Volar Locking Plates?

Clin Orthop Surg. 2020-2-13

[4]
[Plate Osteosynthesis of Distal Ulna Fractures with Associated Distal Radius Fractures Treated by Open Reduction and Internal Fixation. Short-Term Functional and Radiographic Results].

Acta Chir Orthop Traumatol Cech. 2015

[5]
[Internal fixation of radial shaft fractures: Anatomical and biomechanical principles].

Rozhl Chir. 2015-10

[6]
Assessment of Technical Competence in Distal Radius Fracture Fixation by a Volar Locking Plate: A Global Delphi Consensus Study.

J Hand Surg Am. 2023-9

[7]
Pearls and Pitfalls of the Volar Locking Plating for Distal Radius Fractures.

J Hand Surg Asian Pac Vol. 2016-6

[8]
Methods of assessment of the level of surgeons for minimally invasive fixation of distal radius fractures: "expertise" versus "performance".

Int Orthop. 2023-1

[9]
Radiographic alignment of unstable distal radius fractures fixed with 1 or 2 rows of screws in volar locking plates.

J Hand Surg Am. 2013-2

[10]
[Fixation of fractures of the distal radius using the "nail-plate"].

Oper Orthop Traumatol. 2009-11

引用本文的文献

[1]
Influence of Surgeon's Expertise on the Duration of Approach and Closure during Osteosynthesis of Distal Radius Fractures.

J Wrist Surg. 2024-3-8

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