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计算机辅助导航在髋部骨折手术中可用性差。

Poor usability of computer-assisted navigation for hip fracture surgery.

机构信息

Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, J801, 8200, Aarhus, Denmark.

Corporate HR, MidtSim, Central Denmark Region, Hedeager 5, 8200, Aarhus, Denmark.

出版信息

Arch Orthop Trauma Surg. 2024 Jan;144(1):251-257. doi: 10.1007/s00402-023-05096-2. Epub 2023 Oct 25.

DOI:10.1007/s00402-023-05096-2
PMID:37878075
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10774189/
Abstract

INTRODUCTION

The STRYKER ADAPT computer-assisted navigation system provides intraoperative feedback to the surgeon regarding implant placement of the Gamma3 nail. The usability of the ADAPT system has not been evaluated. The aim of the study was to investigate the perceived usability of the ADAPT system.

MATERIALS AND METHODS

This was a descriptive study with prospectively collected data. ADAPT was introduced at Aarhus University Hospital in February 2021. Prior to introduction, surgeons at the department attended a general introduction to the system. ADAPT was introduced to the surgical nurses and was on display at the surgical ward at more than one occasion, where personal introduction to the system was possible. After introduction, it was mandatory to use ADAPT when using the Gamma3 nail to treat intertrochanteric femur fractures. After each procedure, primary and an eventual supervisor answered a questionnaire, which encompassed the System Usability Scale (SUS) questionnaire. The SUS is a ten-item questionnaire regarding the perceived usability of a system. SUS scores were translated to adjectives, describing user experience on a 7-point adjective scale (worst imaginable, awful, poor, ok, good, excellent, best imaginable). User acceptability, defined as "not acceptable", "marginal" or "acceptable", was also used to interpret the SUS scores.

RESULTS

ADAPT was used in 50 procedures by 29 different surgeons, with varying skill-level. Median SUS-score after first-time use of ADAPT for all 29 surgeons was 43 (range: 5-60), which translated to "poor" or "not acceptable". For surgeons who performed ≥ 3 ADAPT-assisted procedures, there were no statistically significant difference in their first to latest SUS-score (median difference: 4.3, p = 0.5). In free text comments ADAPT was positively described as helpful in placement of K-wire and providing educational opportunities for inexperienced surgeons and negatively as inconsistent, slow, time consuming, and causing excessive fluoroscopy.

CONCLUSIONS

Usability and acceptability of ADAPT was rated as "poor" or "not acceptable" by the majority of operating surgeons. ADAPT has not been used at our institution based on these findings. The System Usability Scale may be used in further research exploring usability and acceptability of novel computer-assisted navigation systems for orthopaedic surgery.

摘要

简介

STRYKER ADAPT 计算机辅助导航系统为外科医生提供 Gamma3 钉植入物放置的术中反馈。ADAPT 系统的可用性尚未得到评估。本研究旨在调查 ADAPT 系统的感知可用性。

材料与方法

这是一项描述性研究,数据为前瞻性收集。ADAPT 于 2021 年 2 月在奥胡斯大学医院引入。在引入之前,该部门的外科医生参加了系统的一般性介绍。ADAPT 向外科护士介绍,并在外科病房多次展示,以便对系统进行个人介绍。引入后,在使用 Gamma3 钉治疗转子间股骨骨折时必须使用 ADAPT。每次手术后,初级和最终主管都要回答一份问卷,其中包括系统可用性量表(SUS)问卷。SUS 是一个包含 10 个项目的问卷,涉及系统的感知可用性。SUS 评分被翻译成形容词,在 7 点形容词量表上描述用户体验(最差可想象、糟糕、差、尚可、好、优秀、最佳可想象)。还使用用户可接受性(定义为“不可接受”、“边缘”或“可接受”)来解释 SUS 评分。

结果

ADAPT 由 29 名不同技能水平的外科医生在 50 例手术中使用。所有 29 名外科医生首次使用 ADAPT 的中位数 SUS 评分为 43(范围:5-60),这表示“差”或“不可接受”。对于进行了≥3 次 ADAPT 辅助手术的外科医生,他们的首次和最新 SUS 评分之间没有统计学上的显著差异(中位数差异:4.3,p=0.5)。在自由文本评论中,ADAPT 被描述为在 K 线放置方面很有帮助,并为经验不足的外科医生提供了教育机会,同时也被描述为不一致、缓慢、耗时且导致过多的透视。

结论

大多数手术外科医生认为 ADAPT 的可用性和可接受性为“差”或“不可接受”。根据这些发现,ADAPT 并未在我们的机构使用。系统可用性量表可用于进一步研究探索新型计算机辅助导航系统在骨科手术中的可用性和可接受性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad01/10774189/86bd24245a2f/402_2023_5096_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad01/10774189/bf279917444e/402_2023_5096_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad01/10774189/f039bb3c83bd/402_2023_5096_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad01/10774189/86bd24245a2f/402_2023_5096_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad01/10774189/bf279917444e/402_2023_5096_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad01/10774189/f039bb3c83bd/402_2023_5096_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad01/10774189/86bd24245a2f/402_2023_5096_Fig3_HTML.jpg

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