Schmidt, Mona W und Haney, Caelan M und Kowalewski, Karl-Friedrich und Bintintan, Vasile V und Abu Hilal, Mohammed und Arezzo, Alberto und Bahra, Marcus und Besselink, Marc G und Biebl, Matthias und Boni, Luigi und Diana, Michele und Egberts, Jan H und Fischer, Lars und Francis, Nader und Hashimoto, Daniel A und Perez, Daniel und Schijven, Marlies und Schmelzle, Moritz und Soltes, Marek und Swanstrom, Lee und Welsch, Thilo und Müller-Stich, Beat P und Nickel, Felix
(2022)
Development and validity evidence of an objective structured assessment of technical skills score for minimally invasive linear-stapled, hand-sewn intestinal anastomoses: the A-OSATS score.
Surgical endoscopy, 36 (6).
pp. 4529-4541.
ISSN 1432-2218
Für diesen Eintrag wurde kein Volltext-Dokument angefügt.
Kurzfassung
INTRODUCTION
The aim of this study was to develop a reliable objective structured assessment of technical skills (OSATS) score for linear-stapled, hand-sewn closure of enterotomy intestinal anastomoses (A-OSATS).
MATERIALS AND METHODS
The Delphi methodology was used to create a traditional and weighted A-OSATS score highlighting the more important steps for patient outcomes according to an international expert consensus. Minimally invasive novices, intermediates, and experts were asked to perform a minimally invasive linear-stapled intestinal anastomosis with hand-sewn closure of the enterotomy in a live animal model either laparoscopically or robot-assisted. Video recordings were scored by two blinded raters assessing intrarater and interrater reliability and discriminative abilities between novices (n = 8), intermediates (n = 24), and experts (n = 8).
RESULTS
The Delphi process included 18 international experts and was successfully completed after 4 rounds. A total of 4 relevant main steps as well as 15 substeps were identified and a definition of each substep was provided. A maximum of 75 points could be reached in the unweighted A-OSATS score and 170 points in the weighted A-OSATS score respectively. A total of 41 anastomoses were evaluated. Excellent intrarater (r = 0.807-0.988, p < 0.001) and interrater (intraclass correlation coefficient = 0.923-0.924, p < 0.001) reliability was demonstrated. Both versions of the A-OSATS correlated well with the general OSATS and discriminated between novices, intermediates, and experts defined by their OSATS global rating scale.
CONCLUSION
With the weighted and unweighted A-OSATS score, we propose a new reliable standard to assess the creation of minimally invasive linear-stapled, hand-sewn anastomoses based on an international expert consensus. Validity evidence in live animal models is provided in this study. Future research should focus on assessing whether the weighted A-OSATS exceeds the predictive capabilities of patient outcomes of the unweighted A-OSATS and provide further validity evidence on using the score on different anastomotic techniques in humans.
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