Development and Validation of an Objective Scoring Tool for Robot-Assisted Radical Prostatectomy: Prostatectomy Assessment and Competency Evaluation

Hussein, Ahmed A.; Ghani, Khurshid R.; Peabody, James O.; Sarle, Richard; Abaza, Ronney; Eun, Daniel; Hu, Jim C.; Fumo, Michael; Lane, Brian R.; Montgomery, Jeffrey S.; Hinata, Nobuyuki; Rooney, Deborah M.; Comstock, Bryan A.; Chan, Hei Kit; Mane, Sridhar S.; Mohler, James L.; Wilding, Gregory E.; Miller, David C.; Collaborative, Michigan Urological Surgery Improvement

doi:10.1016/j.juro.2016.11.100

Cited by 50 publications

(42 citation statements)

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“…Objective Structured Assessment of Technical Skills (OSATS) and Global Evaluative Assessment of Robotic Skills (GEARS) are examples that have been extensively evaluated and validated . Furthermore, procedure‐ and task‐specific evaluations have also been developed with the Prostatectomy Assessment and Competency Evaluation (PACE), the RARP Assessment Score, and the Robotic Anastomosis Competency Evaluation (RACE) .…”

Section: Introductionmentioning

confidence: 99%

Experts vs super‐experts: differences in automated performance metrics and clinical outcomes for robot‐assisted radical prostatectomy

Hung

Chen

et al. 2018

BJU International

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ObjectivesTo evaluate automated performance metrics (APMs) and clinical data of experts and super-experts for four cardinal steps of robot-assisted radical prostatectomy (RARP): bladder neck dissection; pedicle dissection; prostate apex dissection; and vesico-urethral anastomosis. Subjects and MethodsWe captured APMs (motion tracking and system events data) and synchronized surgical video during RARP. APMs were compared between two experience levels: experts (100-750 cases) and super-experts (2100-3500 cases). Clinical outcomes (peri-operative, oncological and functional) were then compared between the two groups. APMs and outcomes were analysed for 125 RARPs using multi-level mixed-effect modelling. ResultsFor the four cardinal steps selected, super-experts showed differences in select APMs compared with experts (P < 0.05). Despite similar PSA and Gleason scores, super-experts outperformed experts clinically with regard to peri-operative outcomes, with a greater lymph node yield of 22.6 vs 14.9 nodes, respectively (P < 0.01), less blood loss (125 vs 130 mL, respectively; P < 0.01), and fewer readmissions at 30 days (1% vs 13%, respectively; P = 0.02). A similar but nonsignificant trend was seen for oncological and functional outcomes, with super-experts having a lower rate of biochemical recurrence compared with experts (5% vs 15%, respectively; P = 0.13) and a higher continence rate at 3 months (36% vs 18%, respectively; P = 0.14). ConclusionWe found that experts and super-experts differed significantly in select APMs for the four cardinal steps of RARP, indicating that surgeons do continue to improve in performance even after achieving expertise. We hope ultimately to identify associations between APMs and clinical outcomes to tailor interventions to surgeons and optimize patient outcomes.

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Section: Introductionmentioning

confidence: 99%

Experts vs super‐experts: differences in automated performance metrics and clinical outcomes for robot‐assisted radical prostatectomy

Hung

Chen

et al. 2018

BJU International

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“…7,10,11 The eld of video review and postoperative results analysis is focused on predicting postoperative results and reducing complications. 1,2,12,13 Even though multiple groups have investigated the possibility of video review it is unclear if video review has found its place in daily clinical practice. Earlier research of our group has shown Dutch experts are willing to participate in surgical video review.…”

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Radical Prostatectomy: A Survey on the Influence of Postoperative Results Analysis and Surgical Video Review on Postoperative Complications and Functional Results.

Beulens

Veerman

Brinkman

et al. 2020

Preprint

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Background: Effective training and assessment of performance are fundamental to ensuring that surgeons reach their intended goal and operate safely with maximum preservation of functions. The field of video review and postoperative results analysis is focused on predicting postoperative results and reducing complications. Even though multiple groups have investigated the possibility of video review it is unclear if video review has found its place in daily clinical practice. To investigate the experiences and opinions of surgeons in the field of Robot-assisted Radical Prostatectomy (RARP) on the influence of video reviews and postoperative results analysis on postoperative complications and functional results.Design, Setting, and Participants: RARP surgeons who were expected to perform video reviews and postoperative results analysis were identified. A total of 93 RARP surgeons were invited to participate in this survey. Online questionnaires were distributed. The questionnaire contained the following domains: background information of the RARP surgeons, evaluation of the use of postoperative results analysis and surgical video review, and future recommendations.Results: A total of 30 RARP surgeons responded to the questionnaire. 27 respondents organized periodical results analyses, 17 of them reviewed edited videos as part of standard clinical practice in their hospital. Most respondents recommend video review, and are convinced it improves outcomes through self-reflection, feedback from a colleague, or from seeing different techniques and ‘tricks’. Conclusion: RARP surgeons have accepted the implementation of postoperative results analysis and surgical video review as forms of quality assurance and self-reflection. They use edited surgical videos to gain insight into the specific facets of RARP related to postoperative complications and functional outcomes.

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“…Risk assessment tools can help to estimate the probability that an individual with a given set of risk factors will develop a disease of interest, as well as detect high-risk populations for a given disease [15,16]. So far, such risk assessment tools have been widely applied to the clinical prediction of various cancers [15,17,18], resulting in the identification of several expression-based lncRNA signatures as risk assessment tools for OC [3,6,9,19]. However, as the risk assessment tools for OC are still limited, more research is necessary to more exhaustively establish a set of reliable tools for risk prediction.…”

Section: Introductionmentioning

confidence: 99%

A novel risk score system for assessment of ovarian cancer based on co-expression network analysis and expression level of five lncRNAs

Zhao

Fan

2019

BMC Med Genet

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Background: Ovarian cancer (OC) is the most deadly gynaecological cancer, contributing significantly to female cancer-related deaths worldwide. Improving the outlook for OC patients depends on the identification of more reliable prognostic biomarkers for early diagnosis and survival prediction. The various roles of long non-coding RNAs (lncRNAs) in OC have attracted increasing attention. This study aimed to identify a lncRNA-based signature for survival prediction in OC patients. Methods: RNA expression data and clinical information from a large number of OC patients were downloaded from a public database. These data were regarded as a training set to construct a weighed gene co-expression network analysis (WGCNA) network, mine stable modules, and screen differentially expressed lncRNAs. The prognostic lncRNAs were screened using univariate Cox regression analysis and the optimal prognosis lncRNA combination was screened using a Cox-PH model. The finalised lncRNA combination was used to construct the risk score system, which was validated and assessed for effectiveness using other independent datasets. Further functional pathway enrichment was performed using gene set enrichment analysis (GSEA). Results: A co-expression network was constructed and four stable modules with OC-related biological functions were obtained. A total of 19 lncRNAs significantly related to prognosis of ovarian cancer were obtained using univariate Cox regression analysis, and the 5 prognostic signature lncRNAs GAS5, HCP5, PART1, SNHG11, and SNHG5 were used to establish a risk assessment system. The reliability of the prognostic scoring system was further confirmed using validation sets, which indicated that the risk assessment system could be used as an independent prognostic factor. Pathway enrichment analysis revealed that the network modules related to the above five prognostic genes were significantly associated with cell local adhesion, cancer signaling pathways, JAK-STAT signalling, and endogenous cell receptor interaction. Conclusions: The risk score system established in this study could provide a novel reliable method to identify individuals at high risk of OC. In addition, the five prognostic lncRNAs identified here are promising potential prognostic biomarkers that could help to elucidate the pathogenesis of OC.

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Development and Validation of an Objective Scoring Tool for Robot-Assisted Radical Prostatectomy: Prostatectomy Assessment and Competency Evaluation

Abstract: PACE is a structured, procedure specific and reliable tool that objectively measures surgical performance during robot-assisted radical prostatectomy. It can differentiate different levels of expertise and provide structured feedback to customize training and surgical quality improvement.

Cited by 50 publications

References 30 publications

Experts vs super‐experts: differences in automated performance metrics and clinical outcomes for robot‐assisted radical prostatectomy

Experts vs super‐experts: differences in automated performance metrics and clinical outcomes for robot‐assisted radical prostatectomy

Robot-Assisted Radical Prostatectomy: A Survey on the Influence of Postoperative Results Analysis and Surgical Video Review on Postoperative Complications and Functional Results.

A novel risk score system for assessment of ovarian cancer based on co-expression network analysis and expression level of five lncRNAs

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