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
© 2021. The Author(s)..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Surgical endoscopy - 36(2022), 6 vom: 09. Juni, Seite 4529-4541 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Schmidt, Mona W [VerfasserIn] |
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| Links: |
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| Themen: |
Anastomosis |
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| Anmerkungen: |
Date Completed 12.05.2022 Date Revised 28.01.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00464-021-08806-2 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM332932060 |
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| 100 | 1 | |a Schmidt, Mona W |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Development and validity evidence of an objective structured assessment of technical skills score for minimally invasive linear-stapled, hand-sewn intestinal anastomoses |b the A-OSATS score |
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| 500 | |a Date Revised 28.01.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. The Author(s). | ||
| 520 | |a 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) | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Anastomosis | |
| 650 | 4 | |a Delphi method | |
| 650 | 4 | |a Minimally invasive surgery | |
| 650 | 4 | |a OSATS | |
| 650 | 4 | |a Skill assessment | |
| 700 | 1 | |a Haney, Caelan M |e verfasserin |4 aut | |
| 700 | 1 | |a Kowalewski, Karl-Friedrich |e verfasserin |4 aut | |
| 700 | 1 | |a Bintintan, Vasile V |e verfasserin |4 aut | |
| 700 | 1 | |a Abu Hilal, Mohammed |e verfasserin |4 aut | |
| 700 | 1 | |a Arezzo, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Bahra, Marcus |e verfasserin |4 aut | |
| 700 | 1 | |a Besselink, Marc G |e verfasserin |4 aut | |
| 700 | 1 | |a Biebl, Matthias |e verfasserin |4 aut | |
| 700 | 1 | |a Boni, Luigi |e verfasserin |4 aut | |
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| 700 | 1 | |a Fischer, Lars |e verfasserin |4 aut | |
| 700 | 1 | |a Francis, Nader |e verfasserin |4 aut | |
| 700 | 1 | |a Hashimoto, Daniel A |e verfasserin |4 aut | |
| 700 | 1 | |a Perez, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Schijven, Marlies |e verfasserin |4 aut | |
| 700 | 1 | |a Schmelzle, Moritz |e verfasserin |4 aut | |
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| 700 | 1 | |a Welsch, Thilo |e verfasserin |4 aut | |
| 700 | 1 | |a Müller-Stich, Beat P |e verfasserin |4 aut | |
| 700 | 1 | |a Nickel, Felix |e verfasserin |4 aut | |
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