Hu Tingting, Yan Qiong, Wang Xianke, Yue Gefen, Yu Peng, Cheng Xiangwei, Yan Pengfei
Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China.
Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China.
BMC Nurs. 2024 Sep 11;23(1):641. doi: 10.1186/s12912-024-02323-y.
This study investigates the precision of nurse practitioners (NPs) in measuring intracranial lesion volumes using the ABC/2 method, a simple yet widely used technique in neurosurgical practices. Amidst physician workforce shortages, the role of NPs in clinical practice, including specialized tasks like lesion volume estimation, is gaining importance.
We conducted a retrospective study involving patients treated for intracranial meningiomas. NPs estimated tumor volumes using the ABC/2 method, which was then compared with automated ABC/2 estimations considered as the gold standard. Statistical analyses, including paired sample t-tests, Bland-Altman analysis, and Intraclass Correlation Coefficient (ICC) analysis, were employed to assess measurement accuracy and consistency.
Among the 265 meningioma patients included, NPs measured the average tumor volume as 36.95 ml, generally underestimating it compared to the 39.57 ml average obtained by the automated ABC/2 method. This underestimation, however, was clinically modest, indicated by an average percentage difference of 6.59% and a Cohen's d value of 0.08. Consistency in measurements, assessed using Bland-Altman and ICC analyses, demonstrated a high level of agreement between NPs measurements and the automated method. Additionally, no significant differences in measurement accuracy were observed either among different NPs or across NPs with varying levels of work experience.
Nurse practitioners can effectively employ the ABC/2 method for estimating intracranial lesion volumes with reasonable accuracy and consistency, irrespective of their work experience. This finding is pivotal in enhancing the role of NPs in neurosurgical practices and could be significant in alleviating the strain caused by the global shortage of physicians. Future research may explore extending NPs' roles in other clinical diagnostic and therapeutic tasks.
本研究调查了执业护士(NP)使用ABC/2方法测量颅内病变体积的准确性,ABC/2方法是神经外科实践中一种简单但广泛使用的技术。在医生劳动力短缺的情况下,NP在临床实践中的作用,包括像病变体积估计这样的专业任务,正变得越来越重要。
我们进行了一项回顾性研究,涉及接受颅内脑膜瘤治疗的患者。NP使用ABC/2方法估计肿瘤体积,然后将其与被视为金标准的自动ABC/2估计值进行比较。采用包括配对样本t检验、Bland-Altman分析和组内相关系数(ICC)分析在内的统计分析来评估测量准确性和一致性。
在纳入的265例脑膜瘤患者中,NP测量的平均肿瘤体积为36.95毫升,与自动ABC/2方法获得的平均39.57毫升相比,总体上低估了。然而,这种低估在临床上并不严重,平均百分比差异为6.59%,科恩d值为0.08。使用Bland-Altman和ICC分析评估的测量一致性表明,NP测量值与自动方法之间具有高度一致性。此外,在不同的NP之间或具有不同工作经验水平的NP之间,未观察到测量准确性的显著差异。
无论工作经验如何,执业护士都可以有效地使用ABC/2方法以合理的准确性和一致性估计颅内病变体积。这一发现对于增强NP在神经外科实践中的作用至关重要,并且在缓解全球医生短缺造成的压力方面可能具有重要意义。未来的研究可以探索扩大NP在其他临床诊断和治疗任务中的作用。