Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland.
Edinburgh Surgical Sabermetrics Group, University of Edinburgh, Edinburgh, Scotland.
Ann Surg. 2024 Jun 1;279(6):973-984. doi: 10.1097/SLA.0000000000006211. Epub 2024 Jan 23.
To evaluate the current evidence for surgical sabermetrics: digital methods of assessing surgical nontechnical skills and investigate the implications for enhancing surgical performance.
Surgeons need high-quality, objective, and timely feedback to optimize performance and patient safety. Digital tools to assess nontechnical skills have the potential to reduce human bias and aid scalability. However, we do not fully understand which of the myriad of digital metrics of performance assessment have efficacy for surgeons.
A systematic review was conducted by searching PubMed, EMBASE, CINAHL, and PSYCINFO databases following PRISMA-ScR guidelines. MeSH terms and keywords included "Assessment," "Surgeons," and "Technology". Eligible studies included a digital assessment of nontechnical skills for surgeons, residents, and/or medical students within an operative context.
From 19,229 articles screened, 81 articles met the inclusion criteria. The studies varied in surgical specialties, settings, and outcome measurements. A total of 122 distinct objective, digital metrics were utilized. Studies digitally measured at least 1 category of surgical nontechnical skill using a single (n=54) or multiple objective measures (n=27). The majority of studies utilized simulation (n=48) over live operative settings (n=32). Surgical Sabermetrics has been demonstrated to be beneficial in measuring cognitive load (n=57), situation awareness (n=24), communication (n=3), teamwork (n=13), and leadership (n=2). No studies measured intraoperative decision-making.
The literature detailing the intersection between surgical data science and operative nontechnical skills is diverse and growing rapidly. Surgical Sabermetrics may provide a promising modifiable technique to achieve desirable outcomes for both the surgeon and the patient. This study identifies a diverse array of measurements possible with sensor devices and highlights research gaps, including the need for objective assessment of decision-making. Future studies may advance the integration of physiological sensors to provide a holistic assessment of surgical performance.
评估手术萨比美特学（Surgical Sabermetrics）的现有证据：用于评估手术非技术技能的数字方法，并探讨其对提高手术绩效的影响。
外科医生需要高质量、客观和及时的反馈，以优化绩效和患者安全。用于评估非技术技能的数字工具具有减少人为偏见和辅助可扩展性的潜力。然而，我们并不完全了解众多性能评估的数字指标中哪些对外科医生有效。
按照 PRISMA-ScR 指南，通过搜索 PubMed、EMBASE、CINAHL 和 PSYCINFO 数据库进行系统评价。使用的 MeSH 术语和关键词包括“评估”、“外科医生”和“技术”。纳入标准为在手术环境中对外科医生、住院医师和/或医学生进行数字非技术技能评估的研究。
从筛选出的 19229 篇文章中，有 81 篇文章符合纳入标准。这些研究的外科专业、设置和结果测量各不相同。共使用了 122 种不同的客观、数字指标。研究使用单一（n=54）或多种客观测量（n=27）对至少 1 种外科非技术技能进行了数字测量。大多数研究（n=48）在模拟环境中，而非在实际手术环境中（n=32）进行。已经证明，手术萨比美特学在测量认知负荷（n=57）、情境意识（n=24）、沟通（n=3）、团队合作（n=13）和领导力（n=2）方面是有益的。没有研究测量术中决策。
详细描述手术数据科学与手术非技术技能交叉点的文献多种多样且增长迅速。手术萨比美特学可能提供一种有前途的可修改技术，以实现外科医生和患者都期望的结果。本研究确定了传感器设备可能进行的各种测量，并强调了研究空白，包括对决策进行客观评估的需要。未来的研究可能会推进生理传感器的整合，以提供对手术绩效的全面评估。
