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超声引导下针追踪中商业与低成本凝胶体模的比较:一项针对急诊医学住院医师的随机交叉试验。

Comparing commercial versus low-cost gelatinous phantoms for ultrasound-guided needle tracking: A randomized crossover trial, among emergency medicine residents.

作者信息

Shrimal Prawal, Thakur Nirmal, Gopinath Bharath, Mishra Prakash Ranjan, Rajalekshmi Ranjan, Bhoi Sanjeev, Aggarwal Praveen, Jamshed Nayer, Upadhyay Ashish Datt

机构信息

Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India.

Department of Biostatisics, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Turk J Emerg Med. 2024 Apr 4;24(2):103-110. doi: 10.4103/tjem.tjem_206_23. eCollection 2024 Apr-Jun.

Abstract

OBJECTIVES

The objective of this study was to devise a low-cost indigenous gelatin-based vascular phantom and to compare this newly constructed phantom with a commercially available phantom.

METHODS

This was a randomized crossover study conducted at a tertiary care hospital of India. The aim of the study was to develop a prototype low-cost gelatin-based vascular phantom and compare it with a commercially available phantom. Gelatin, psyllium husk, corn starch, antiseptic liquid, food-coloring agent, latex balloons, and metallic containers were used to prepare the gelatin phantom. The newly prepared gelatin model was labeled "Model A" and the commercially available gelatin model was labeled "Model B." Emergency medicine residents ( = 34) who routinely perform ultrasound (USG)-guided invasive procedures were asked to demonstrate USG-guided in-plane and out-of-plane approach of needle-tracking in both the models and fill out a questionnaire on a Likert scale (1-5). An independent supervisor assessed the image quality.

RESULTS

The cost of our phantom was USD 6-8 (vs. USD 1000-1200 for commercial phantom). The participants rated the ease of performance and tissue resemblance as 4 (interquartile range [IQR]: 4-5) for both the models "A" and "B." The supervisor rated the overall performance as 4 (IQR: 3-4) for both the models. In all the parameters assessed, model A was noninferior to model B.

CONCLUSION

The indigenously developed vascular phantom was noninferior to the commercially available phantom in terms of tissue resemblance and overall performance. The cost involved was a fraction of that incurred with the currently available commercial model. The authors feel that gelatin-based models can be easily prepared in resource-constraint settings which may be used for USG-guided training and medical education in low- and middle-income countries.

摘要

目的

本研究的目的是设计一种低成本的国产明胶基血管模型,并将新构建的模型与市售模型进行比较。

方法

这是一项在印度一家三级护理医院进行的随机交叉研究。该研究的目的是开发一种低成本的明胶基血管模型原型,并将其与市售模型进行比较。使用明胶、车前子壳、玉米淀粉、防腐液、食用色素、乳胶气球和金属容器来制备明胶模型。新制备的明胶模型标记为“A模型”,市售明胶模型标记为“B模型”。要求经常进行超声(USG)引导下侵入性操作的急诊医学住院医师(n = 34)在两种模型中演示USG引导的针跟踪平面内和平面外方法,并填写一份李克特量表(1 - 5)的问卷。一名独立监督员评估图像质量。

结果

我们的模型成本为6 - 8美元(而商业模型为1000 - 1200美元)。参与者对“A”和“B”两种模型的操作简易程度和组织相似性的评分均为4(四分位间距[IQR]:4 - 5)。监督员对两种模型的整体性能评分均为4(IQR:3 - 4)。在所有评估参数中,A模型不劣于B模型。

结论

国产血管模型在组织相似性和整体性能方面不劣于市售模型。所涉及的成本只是当前可用商业模型成本的一小部分。作者认为,基于明胶的模型可以在资源有限的环境中轻松制备,可用于低收入和中等收入国家的超声引导培训和医学教育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5568/11100574/5bed8d5d14dd/TJEM-24-103-g001.jpg

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