Hierarchical task analysis of endoscopic sleeve gastroplasty.
Bariatric endoscopy
Endoscopic simulator
Endoscopic sleeve gastroplasty
Hierarchical task analysis
Medical education
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
29
03
2021
accepted:
16
11
2021
pubmed:
1
12
2021
medline:
7
6
2022
entrez:
30
11
2021
Statut:
ppublish
Résumé
Endoscopic sleeve gastroplasty (ESG) is a minimally invasive endoscopic weight loss procedure used to treat obesity. The long-term goal of this project is to develop a Virtual Bariatric Endoscopy (ViBE) simulator for training and assessment of the ESG procedure. The objectives of this current work are to: (a) perform a task analysis of ESG and (b) create metrics to be validated in the created simulator. We performed a hierarchical task analysis (HTA) by identifying the significant tasks of the ESG procedure. We created the HTA to show the breakdown and connection of the tasks of the procedure. Utilizing the HTA and input from ESG experts, performance metrics were derived for objective measurement of the ESG procedure. Three blinded video raters analyzed seven recorded ESG procedures according to the proposed performance metrics. Based on the seven videos, there was a positive correlation between total task times and total performance scores (R = 0.886, P = 0.008). Endoscopists expert were found to be more skilled in reducing the area of the stomach compared to endoscopists novice (34.6% reduction versus 9.4% reduction, P = 0.01). The mean novice performance score was significantly lower than the mean expert performance score (34.7 vs. 23.8, P = 0.047). The inter-rater reliability test showed a perfect agreement among three raters for all tasks except for the suturing task. The suturing task had a significant agreement (Inter-rater Correlation = 0.84, Cronbach's alpha = 0.88). Suturing was determined to be a critical task that is positively correlated with the total score (R = 0.962, P = 0.0005). The task analysis and metrics development are critical for the development of the ViBE simulator. This preliminary assessment demonstrates that the performance metrics provide an accurate assessment of the endoscopist's performance. Further validation testing and refinement of the performance metrics are anticipated.
Sections du résumé
BACKGROUND
Endoscopic sleeve gastroplasty (ESG) is a minimally invasive endoscopic weight loss procedure used to treat obesity. The long-term goal of this project is to develop a Virtual Bariatric Endoscopy (ViBE) simulator for training and assessment of the ESG procedure. The objectives of this current work are to: (a) perform a task analysis of ESG and (b) create metrics to be validated in the created simulator.
METHODS
We performed a hierarchical task analysis (HTA) by identifying the significant tasks of the ESG procedure. We created the HTA to show the breakdown and connection of the tasks of the procedure. Utilizing the HTA and input from ESG experts, performance metrics were derived for objective measurement of the ESG procedure. Three blinded video raters analyzed seven recorded ESG procedures according to the proposed performance metrics.
RESULTS
Based on the seven videos, there was a positive correlation between total task times and total performance scores (R = 0.886, P = 0.008). Endoscopists expert were found to be more skilled in reducing the area of the stomach compared to endoscopists novice (34.6% reduction versus 9.4% reduction, P = 0.01). The mean novice performance score was significantly lower than the mean expert performance score (34.7 vs. 23.8, P = 0.047). The inter-rater reliability test showed a perfect agreement among three raters for all tasks except for the suturing task. The suturing task had a significant agreement (Inter-rater Correlation = 0.84, Cronbach's alpha = 0.88). Suturing was determined to be a critical task that is positively correlated with the total score (R = 0.962, P = 0.0005).
CONCLUSION
The task analysis and metrics development are critical for the development of the ViBE simulator. This preliminary assessment demonstrates that the performance metrics provide an accurate assessment of the endoscopist's performance. Further validation testing and refinement of the performance metrics are anticipated.
Identifiants
pubmed: 34845547
doi: 10.1007/s00464-021-08893-1
pii: 10.1007/s00464-021-08893-1
pmc: PMC9148380
mid: NIHMS1763399
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
5167-5182Subventions
Organisme : NIBIB NIH HHS
ID : R56EB026490
Pays : United States
Organisme : NIGMS NIH HHS
ID : P20 GM103429
Pays : United States
Organisme : NIH HHS
ID : 1R01EB025241
Pays : United States
Organisme : NIBIB NIH HHS
ID : R56 EB026490
Pays : United States
Organisme : NCI NIH HHS
ID : 5R01CA197491
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA197491
Pays : United States
Organisme : NIBIB NIH HHS
ID : R01 EB025241
Pays : United States
Organisme : NIAMS NIH HHS
ID : R44 AR075481
Pays : United States
Organisme : NIAMS NIH HHS
ID : R44AR075481-01
Pays : United States
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Ogden CL, Carroll MD, Kit BK, Flegal KM (2014) Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 311(8):806–814. https://doi.org/10.1001/jama.2014.732
doi: 10.1001/jama.2014.732
pubmed: 24570244
pmcid: 4770258
M. dos P. Galvão-Neto, E. Grecco, T. F. de Souza, L. G. de Quadros, L. B. Silva, and J. M. Campos (2016) “Endoscopic sleeve gastroplasty—minimally invasive therapy for primary obesity treatment,” ABCD, arq. bras. cir. dig 29(1): 95–97. https://doi.org/10.1590/0102-6720201600s10023 .
Kissler HJ, Settmacher U (2013) Bariatric surgery to treat obesity. Semin Nephrol 33(1):75–89. https://doi.org/10.1016/j.semnephrol.2012.12.004
doi: 10.1016/j.semnephrol.2012.12.004
pubmed: 23374896
Mechanick JI et al (2013) Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American association of clinical endocrinologists, the obesity society, and American society for metabolic & bariatric surgery. Surg Obes Relat Dis 9(2):159–191. https://doi.org/10.1016/j.soard.2012.12.010
doi: 10.1016/j.soard.2012.12.010
pubmed: 23537696
Birkmeyer JD et al (2013) Surgical skill and complication rates after bariatric surgery. N Engl J Med 369(15):1434–1442. https://doi.org/10.1056/NEJMsa1300625
doi: 10.1056/NEJMsa1300625
pubmed: 24106936
Abu Dayyeh BK et al (2017) Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clin Gastroenterol Hepatol 15(1):37-43.e1. https://doi.org/10.1016/j.cgh.2015.12.030
doi: 10.1016/j.cgh.2015.12.030
pubmed: 26748219
Sharaiha RZ et al (2020) Five-year outcomes of endoscopic sleeve gastroplasty for the treatment of obesity. Clin Gastroenterol Hepatol. https://doi.org/10.1016/j.cgh.2020.09.055
doi: 10.1016/j.cgh.2020.09.055
pubmed: 33011292
pmcid: 7194523
Sharaiha RZ et al (2017) Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol 15(4):504–510. https://doi.org/10.1016/j.cgh.2016.12.012
doi: 10.1016/j.cgh.2016.12.012
pubmed: 28017845
“STAR Certificate Programs,” Default. https://www.asge.org/home/education/advanced-education-training/star-certificate-programs . Accessed 16 Dec 2020.
Bazarbashi AN (2020) Training in bariatric endoscopy. ACG Case Rep J. https://doi.org/10.14309/crj.0000000000000358
doi: 10.14309/crj.0000000000000358
pubmed: 33062778
pmcid: 7535658
Lopez-Nava G et al (2017) Endoscopic sleeve gastroplasty for obesity: a multicenter study of 248 patients with 24 months follow-up. Obes Surg 27(10):2649–2655. https://doi.org/10.1007/s11695-017-2693-7
doi: 10.1007/s11695-017-2693-7
pubmed: 28451929
Hill C et al (2017) Endoscopic sleeve gastroplasty: the learning curve. Endosc Int Open 5(9):E900–E904. https://doi.org/10.1055/s-0043-115387
doi: 10.1055/s-0043-115387
pubmed: 28924597
pmcid: 5597932
Farmer J et al (2020) Systematic approach for content and construct validation: case studies for arthroscopy and laparoscopy. Int J Med Robot Comput Assist Surg 16(4):e2105. https://doi.org/10.1002/rcs.2105
doi: 10.1002/rcs.2105
Kühnapfel U, Çakmak HK, Maaß H (2000) Endoscopic surgery training using virtual reality and deformable tissue simulation. Comput Graph 24(5):671–682. https://doi.org/10.1016/S0097-8493(00)00070-4
doi: 10.1016/S0097-8493(00)00070-4
Qi D et al (2020) Surgeons with five or more actual cricothyrotomies perform significantly better on a virtual reality simulator. J Surg Res 252:247–254. https://doi.org/10.1016/j.jss.2020.03.021
doi: 10.1016/j.jss.2020.03.021
pubmed: 32304931
pmcid: 7295680
Demirel D et al (2016) Virtual airway skills trainer (VAST) simulator. Stud Health Technol Inform 220:91–97
pubmed: 27046559
pmcid: 5033599
J. Farmer et al., “Virtual rotator cuff arthroscopic skill trainer: Results and analysis of a preliminary subject study,” In: Proceedings of the 2020 the 4th International Conference on Information System and Data Mining, New York, NY, USA, May 2020, pp. 139–143, https://doi.org/10.1145/3404663.3404673 .
“Application of virtual reality technology in clinical medicine.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622235/ . Accessed 18 Nov 2020.
Luciano C, Banerjee P, DeFanti T (2009) Haptics-based virtual reality periodontal training simulator. Virtual Reality 13:69–85. https://doi.org/10.1007/s10055-009-0112-7
doi: 10.1007/s10055-009-0112-7
Samadbeik M, Yaaghobi D, Bastani P, Abhari S, Rezaee R, Garavand A (2018) The applications of virtual reality technology in medical groups teaching. J Adv Med Educ Prof 6(3):123–129
pubmed: 30013996
pmcid: 6039818
Sankaranarayanan G et al (2011) Validation of a novel laparoscopic adjustable gastric band simulator. Surg Endosc 25(4):1012–1018. https://doi.org/10.1007/s00464-010-1306-5
doi: 10.1007/s00464-010-1306-5
pubmed: 20734069
Lewis TM et al (2012) Can virtual reality simulation be used for advanced bariatric surgical training? Surgery 151(6):779–784. https://doi.org/10.1016/j.surg.2012.03.014
doi: 10.1016/j.surg.2012.03.014
pubmed: 22652118
Stefanidis D, Heniford BT (2009) The formula for a successful laparoscopic skills curriculum. Arch Surg 144:77–82. https://doi.org/10.1001/archsurg.2008.528 (discussion 82)
doi: 10.1001/archsurg.2008.528
pubmed: 19153329
Demirel D et al (2016) A hierarchical task analysis of cricothyroidotomy procedure for a virtual airway skills trainer (VAST) simulator. Am J Surg 212(3):475–484. https://doi.org/10.1016/j.amjsurg.2015.08.029
doi: 10.1016/j.amjsurg.2015.08.029
pubmed: 26590044
Hazey JW et al (2014) Why fundamentals of endoscopic surgery (FES)? Surg Endosc 28(3):701–703. https://doi.org/10.1007/s00464-013-3299-3
doi: 10.1007/s00464-013-3299-3
pubmed: 24317546
Hollnagel E (2003) Handbook of cognitive task design. CRC Press, Boca Raton
doi: 10.1201/9781410607775
Cetinsaya B et al (2019) A task and performance analysis of endoscopic submucosal dissection (ESD) surgery. Surg Endosc 33(2):592–606. https://doi.org/10.1007/s00464-018-6379-6
doi: 10.1007/s00464-018-6379-6
pubmed: 30128824
Demirel D et al (2017) A hierarchical task analysis of shoulder arthroscopy for a virtual arthroscopic tear diagnosis and evaluation platform (VATDEP). Int J Med Robot Comput Assist Surg 13(3):e1799. https://doi.org/10.1002/rcs.1799
doi: 10.1002/rcs.1799
Corbett M, O’Connor P, Byrne D, Thornton M, Keogh I (2019) Identifying and reducing risks in functional endoscopic sinus surgery through a hierarchical task analysis. Laryngoscope Investig Otolaryngol 4(1):5–12. https://doi.org/10.1002/lio2.220
doi: 10.1002/lio2.220
pubmed: 30828612
Myers EM, Anderson-Montoya BL, Fasano HT, Vilasagar S, Tarr ME (2019) Robotic sacrocolpopexy simulation model and associated hierarchical task analysis. Obstet Gynecol 133(5):905–909. https://doi.org/10.1097/AOG.0000000000003218
doi: 10.1097/AOG.0000000000003218
pubmed: 30969216
Wucherer P et al (2015) Vertebroplasty performance on simulator for 19 surgeons using hierarchical task analysis. IEEE Trans Med Imaging 34(8):1730–1737. https://doi.org/10.1109/TMI.2015.2389033
doi: 10.1109/TMI.2015.2389033
pubmed: 25585414
Lane R, Stanton NA, Harrison D (2006) Applying hierarchical task analysis to medication administration errors. Appl Ergon 37(5):669–679. https://doi.org/10.1016/j.apergo.2005.08.001
doi: 10.1016/j.apergo.2005.08.001
pubmed: 16182230
Phipps D, Meakin GH, Beatty PCW, Nsoedo C, Parker D (2008) Human factors in anaesthetic practice: insights from a task analysis. Br J Anaesth 100(3):333–343. https://doi.org/10.1093/bja/aem392
doi: 10.1093/bja/aem392
pubmed: 18238839
Al-Hakim L, Maiping T, Sevdalis N (2014) Applying hierarchical task analysis to improving the patient positioning for direct lateral interbody fusion in spinal surgery. Appl Ergon 45(4):955–966. https://doi.org/10.1016/j.apergo.2013.11.013
doi: 10.1016/j.apergo.2013.11.013
pubmed: 24332824
Kumar N, Thompson CC (2014) A novel method for endoscopic perforation management by using abdominal exploration and full-thickness sutured closure. Gastrointest Endosc 80(1):156–161. https://doi.org/10.1016/j.gie.2014.02.022
doi: 10.1016/j.gie.2014.02.022
pubmed: 24721517
pmcid: 5019098
Joice P, Hanna GB, Cuschieri A (1998) Errors enacted during endoscopic surgery—a human reliability analysis. Appl Ergon 29(6):409–414. https://doi.org/10.1016/S0003-6870(98)00016-7
doi: 10.1016/S0003-6870(98)00016-7
pubmed: 9796785
Gurudu SR, Ramirez FC (2013) Quality metrics in endoscopy. Gastroenterol Hepatol 9(4):228–233
Schulz CM, Krautheim V, Hackemann A, Kreuzer M, Kochs EF, Wagner KJ (2016) Situation awareness errors in anesthesia and critical care in 200 cases of a critical incident reporting system. BMC Anesthesiol 16(1):4. https://doi.org/10.1186/s12871-016-0172-7
doi: 10.1186/s12871-016-0172-7
pubmed: 26772179
pmcid: 4715310
Alqahtani A, Al-Darwish A, Mahmoud AE, Alqahtani YA, Elahmedi M (2019) Short-term outcomes of endoscopic sleeve gastroplasty in 1000 consecutive patients. Gastrointest Endosc 89(6):1132–1138. https://doi.org/10.1016/j.gie.2018.12.012
doi: 10.1016/j.gie.2018.12.012
pubmed: 30578757
Asokkumar R, Babu MP, Bautista I, Lopez-Nava G (2020) The use of the overstitch for bariatric weight loss in Europe. Gastrointest Endosc Clin N Am 30(1):129–145. https://doi.org/10.1016/j.giec.2019.08.007
doi: 10.1016/j.giec.2019.08.007
pubmed: 31739959
Zorron R et al (2017) Endoscopic sleeve gastroplasty using Apollo overstitch as a bridging procedure for superobese and high risk patients. Endoscopy. https://doi.org/10.1055/s-0043-119685
doi: 10.1055/s-0043-119685
pubmed: 29041019
Barrichello S et al (2019) Endoscopic sleeve gastroplasty in the management of overweight and obesity: an international multicenter study. Gastrointest Endosc 90(5):770–780. https://doi.org/10.1016/j.gie.2019.06.013
doi: 10.1016/j.gie.2019.06.013
pubmed: 31228432
de Moura DTH, de Moura EGH, Thompson CC (2019) Endoscopic sleeve gastroplasty: from whence we came and where we are going. World J Gastrointest Endosc 11(5):322–328. https://doi.org/10.4253/wjge.v11.i5.322
doi: 10.4253/wjge.v11.i5.322
pubmed: 31205593
pmcid: 6556490
Abràmoff MD, Magalhães PJ, Ram SJ (2004) Image processing with ImageJ. Biophotonics Int 11(7):36–42