Analysis of Simulated Angiographic Procedures. Part 2: Extracting Efficiency Data from Audio and Video Recordings

Duncan, James R.; Kline, B. S.; Glaiberman, Craig B.

doi:10.1016/j.jvir.2007.01.006

Cited by 19 publications

(11 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is the first study of IR simulation that has accurately discriminated across expertise on a number of performance metrics. It is therefore an important addition to existing research into IR simulation that has to date failed to discriminate expertise, although differences across expertise have been reported [11,12]. Length of time to complete a simulated procedure has previously been found to discriminate expertise [6,19] and was confirmed here.…”

Section: Discussionsupporting

confidence: 66%

“…laparascopic surgery [7], colonoscopy [8] and anaesthetics [9]. However, within IR no simulator has met this standard [5,6,10], with validation studies typically failing to discriminate accurately between experts and novices [11], although differences have been observed [12]. Length of time to complete procedures on simulators is a frequently reported expertise discriminator [6] but there is a worrying lack of emphasis on the number of errors made or other clinically relevant parameters.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Virtual reality, ultrasound-guided liver biopsy simulator: development and performance discrimination

Johnson¹,

Hunt²,

Woolnough³

et al. 2012

BJR

View full text Add to dashboard Cite

Objectives: The aim of this article was to identify and prospectively investigate simulated ultrasound-guided targeted liver biopsy performance metrics as differentiators between levels of expertise in interventional radiology. Methods: Task analysis produced detailed procedural step documentation allowing identification of critical procedure steps and performance metrics for use in a virtual reality ultrasound-guided targeted liver biopsy procedure. Consultant (n514; male511, female53) and trainee (n526; male519, female57) scores on the performance metrics were compared. Ethical approval was granted by the Liverpool Research Ethics Committee (UK). Independent t-tests and analysis of variance (ANOVA) investigated differences between groups. Results: Independent t-tests revealed significant differences between trainees and consultants on three performance metrics: targeting, p50.018, t522.487 (22.040 to 20.207); probe usage time, p50.040, t52.132 (11.064 to 427.983); mean needle length in beam, p50.029, t522.272 (20.028 to 20.002). ANOVA reported significant differences across years of experience (0-1, 1-2, 3+ years) on seven performance metrics: no-go area touched, p50.012; targeting, p50.025; length of session, p50.024; probe usage time, p50.025; total needle distance moved, p50.038; number of skin contacts, p,0.001; total time in no-go area, p50.008. More experienced participants consistently received better performance scores on all 19 performance metrics. Conclusion: It is possible to measure and monitor performance using simulation, with performance metrics providing feedback on skill level and differentiating levels of expertise. However, a transfer of training study is required.

show abstract

Section: Discussionsupporting

confidence: 66%

mentioning

confidence: 99%

Virtual reality, ultrasound-guided liver biopsy simulator: development and performance discrimination

Johnson¹,

Hunt²,

Woolnough³

et al. 2012

BJR

View full text Add to dashboard Cite

show abstract

“…By contrast to our study, previous studies that used multivideo recordings in fluoroscopic interventions to evaluate intraprocedural decision-making, focused on third-person perspective, not taking advantage of first-person experience nor paying attention to how limitations in the environment affect performance [26,27].…”

Section: Discussionmentioning

confidence: 59%

Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions: an iliac angioplasty exemplar case study

et al. 2015

View full text Add to dashboard Cite

Purpose A methodological framework is introduced to assess and compare a conventional fluoroscopy protocol for peripheral angioplasty with a new magnetic resonant imaging (MRI)-guided protocol. Different scenarios were considered during interventions on a perfused arterial phantom with regard to time-based and cognitive task analysis, user experience and ergonomics. Methods Three clinicians with different expertise performed a total of 43 simulated common iliac angioplasties (9 fluoroscopic, 34 MRI-guided) in two blocks of sessions. Six different configurations for MRI guidance were tested in the first block. Four of them were evaluated in the sec- ond block and compared to the fluoroscopy protocol. Relevant stages' durations were collected, and interventions were audio-visually recorded from different perspectives. A cued retrospective protocol analysis (CRPA) was undertaken, including personal interviews. In addition, ergonomic constraints in the MRI suite were evaluated. Results Significant differences were found when comparing the performance between MRI configurations versus fluoroscopy. Two configurations [with times of 8.56 (0.64) and 9.48 (1.13) min] led to reduce procedure time for MRI guidance, comparable to fluoroscopy [8.49 (0.75) min]. The CRPA pointed out the main influential factors for clinical procedure performance. The ergonomic analysis quantified musculoskeletal risks for interventional radiologists when utilising MRI. Several alternatives were suggested to prevent potential low-back injuries. Conclusions This work presents a step towards the implementation of efficient operational protocols for MRI-guided procedures based on an integral and multidisciplinary framework, applicable to the assessment of current vascular protocols. The use of first-user perspective raises the possibility of establishing new forms of clinical training and education.

show abstract

“…Our methods of both observation and metric measurement have been described as reliable [17]. However, the machine-generated measures of performance are relatively limited-procedure time, fluoroscopy time, measurement of contrast and balloon or stent position-and are crude measures of performance.…”

Section: Discussionmentioning

confidence: 99%

Training on a vascular interventional simulator: an observational study

et al. 2008

View full text Add to dashboard Cite

Radiology registrars were observed performing a left renal artery angioplasty using a proprietary training simulator up to five times during their first year of training. Total procedure time, fluoroscopy times, and metric information from the machine were recorded. Each step of the procedure was judged by an observer and a mistake profile was generated. Fifty-two runs were completed by 12 trainees. The mean procedure time decreased from 16.6 min to 9.8 min over the five runs. The number of mistakes ranged from zero to ten and the mean number of mistakes made varied from 0.7 to 2.6 per procedure without any particular trend. Our study demonstrates that training on the simulator does improve performance. The mistakes made throughout training indicates the potential benefit from further simulator training. It remains unclear how to integrate this form of training in current educational programs.

show abstract

Analysis of Simulated Angiographic Procedures. Part 2: Extracting Efficiency Data from Audio and Video Recordings

Cited by 19 publications

References 26 publications

Virtual reality, ultrasound-guided liver biopsy simulator: development and performance discrimination

Virtual reality, ultrasound-guided liver biopsy simulator: development and performance discrimination

Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions: an iliac angioplasty exemplar case study

Training on a vascular interventional simulator: an observational study

Contact Info

Product

Resources

About