Yi Xuxia, Wang Gang, Zhang Nai, Si Weixin, Lv Jianping
Department of Neurosurgery, Guangzhou First People's Hospital, Guangzhou, China.
National Center for Mental Health, China, Beijing, China.
Front Neurol. 2023 Feb 16;14:1122257. doi: 10.3389/fneur.2023.1122257. eCollection 2023.
Nowadays, with the fast-increasing demand for neuro-endovascular therapy, surgeons in this field are in urgent need. Unfortunately, there is still no formal skill assessment in neuro-endovascular therapy in China.
We used a Delphi method to design a newly objective checklist for standards of cerebrovascular angiography in China and evaluated its validity and reliability. A total of 19 neuro-residents with no interventional experience and 19 neuro-endovascular surgeons from two centers (Guangzhou and Tianjin) were recruited; they were divided into two groups: residents and surgeons. Residents completed a simulation-based cerebrovascular angiography operation training before assessment. Assessments were under live and video record forms with two tools: the existing global rating scale (GRS) of endovascular performance and the new checklist.
The average scores of residents were significantly increased after training in two centers ( < 0.05). There is good consistency between GRS and the checklist ( = 0.856). Intra-rater reliability (Spearman's rho) of the checklist was >0.9, and the same result was also observed in raters between different centers and different assessment forms ( < 0.001, rho > 0.9). The reliability of the checklist was higher than that of the GRS (Kendall's harmonious coefficient is 0.849, while GRS is 0.684).
The newly developed checklist appears reliable and valid for evaluating the technical performance of cerebral angiography and differentiating between trained and untrained trainees' performance well. For its efficiency, our method has been proven to be a feasible tool for resident angiography examination in certification nationwide.
如今，随着神经血管内治疗需求的快速增长，该领域的外科医生急需补充。不幸的是，在中国，神经血管内治疗仍没有正式的技能评估。
我们采用德尔菲法设计了一份新的中国脑血管造影标准客观检查表，并评估其有效性和可靠性。共招募了来自两个中心（广州和天津）的19名无介入经验的神经科住院医师和19名神经血管内外科医生；他们被分为两组：住院医师组和外科医生组。住院医师在评估前完成了基于模拟的脑血管造影操作培训。评估采用现场和视频记录两种形式，使用两种工具：现有的血管内操作整体评分量表（GRS）和新检查表。
两个中心的住院医师培训后的平均得分均显著提高（<0.05）。GRS与检查表之间具有良好的一致性（=0.856）。检查表的评分者内信度（Spearman相关系数）>0.9，不同中心和不同评估形式的评分者之间也观察到相同结果（<0.001，rho>0.9）。检查表的信度高于GRS（肯德尔和谐系数为0.849，而GRS为0.684）。
新制定的检查表在评估脑血管造影技术操作以及区分受过培训和未受过培训的学员表现方面似乎可靠且有效。因其高效性，我们的方法已被证明是全国范围内住院医师血管造影认证考试的可行工具。
