Development and initial validation of an instrument for video-based assessment of technical skill in ERCP

被引：14

作者：

Elmunzer, B. Joseph ^{[1
]}

Walsh, Catharine M. ^{[2
,3
]}

Guiton, Gretchen ^{[4
]}

Serrano, Jose ^{[5
]}

Chak, Amitabh ^{[6
]}

Edmundowicz, Steven ^{[7
]}

Kwon, Richard S. ^{[8
]}

Mullady, Daniel ^{[9
]}

Papachristou, Georgios, I ^{[10
]}

Elta, Grace ^{[8
]}

Baron, Todd H. ^{[11
]}

Yachimski, Patrick ^{[12
]}

Fogel, Evan L. ^{[13
]}

Draganov, Peter, V ^{[14
]}

Taylor, Jason R. ^{[15
]}

Scheiman, James ^{[16
]}

Singh, Vikesh K. ^{[17
]}

Varadarajulu, Shyam ^{[18
]}

Willingham, Field F. ^{[19
]}

Cote, Gregory A. ^{[1
]}

Cotton, Peter B. ^{[1
]}

Simon, Violette ^{[7
]}

Spitzer, Rebecca ^{[1
]}

Keswani, Rajesh ^{[20
]}

Wani, Sachin ^{[7
]}

机构：

[1] Med Univ South Carolina, Div Gastroenterol & Hepatol, MSC 702,114 Doughty St,Ste 249, Charleston, SC 29425 USA

[2] Hosp Sick Children, Learning Inst, Div Gastroenterol Hepatol & Nutr, Toronto, ON, Canada

[3] Hosp Sick Children, Res Inst, Toronto, ON, Canada

[4] Univ Colorado, Dept Internal Med, Sch Med, Aurora, CO USA

[5] NIDDK, NIH, Bethesda, MD 20892 USA

[6] Case Western Reserve Univ, Div Gastroenterol & Liver Dis, Cleveland, OH 44106 USA

[7] Univ Colorado, Div Gastroenterol & Hepatol, Anschutz Med Campus, Aurora, CO USA

[8] Univ Michigan, Div Gastroenterol, Ann Arbor, MI 48109 USA

[9] Washington Univ, Sch Med, Div Gastroenterol, St Louis, MO 63110 USA

[10] Ohio State Univ, Div Gastroenterol Hepatol & Nutr, Wexner Med Ctr, Columbus, OH 43210 USA

[11] Univ N Carolina, Div Gastroenterol & Hepatol, Chapel Hill, NC 27515 USA

[12] Vanderbilt Univ, Div Gastroenterol, 221 Kirkland Hall, Nashville, TN 37235 USA

[13] Indiana Univ, Div Gastroenterol & Hepatol, Indianapolis, IN 46204 USA

[14] Univ Florida, Div Gastroenterol Hepatol & Nutr, Gainesville, FL USA

[15] St Louis Univ, Div Gastroenterol & Hepatol, St Louis, MO 63103 USA

[16] Univ Virginia, Div Gastroenterol & Hepatol, Charlottesville, VA USA

[17] Johns Hopkins Med Inst, Div Gastroenterol, Baltimore, MD 21205 USA

[18] Advent Hlth, Ctr Intervent Endoscopy, Orlando, FL USA

[19] Emory Univ, Div Digest Dis, Atlanta, GA 30322 USA

[20] Northwestern Univ, Div Gastroenterol, Chicago, IL 60611 USA

来源：

GASTROINTESTINAL ENDOSCOPY | 2021年 / 93卷 / 04期

基金：

美国国家卫生研究院;

关键词：

D O I：

10.1016/j.gie.2020.07.055

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and Aims: The accurate measurement of technical skill in ERCP is essential for endoscopic training, quality assurance, and coaching of this procedure. Hypothesizing that technical skill can be measured by analysis of ERCP videos, we aimed to develop and validate a video-based ERCP skill assessment tool. Methods: Based on review of procedural videos, the task of ERCP was deconstructed into its basic components by an expert panel that developed an initial version of the Bethesda ERCP Skill Assessment Tool (BESAT). Subsequently, 2 modified Delphi panels and 3 validation exercises were conducted with the goal of iteratively refining the tool. Fully crossed generalizability studies investigated the contributions of assessors, ERCP performance, and technical elements to reliability. Results: Twenty-nine technical elements were initially generated from task deconstruction. Ultimately, after iterative refinement, the tool comprised 6 technical elements and 11 subelements. The developmental process achieved consistent improvements in the performance characteristics of the tool with every iteration. For the most recent version of the tool, BESAT-v4, the generalizability coefficient (a reliability index) was.67. Most variance in BESAT scores (43.55%) was attributed to differences in endoscopists' skill, indicating that the tool can reliably differentiate between endoscopists based on video analysis. Conclusions: Video-based assessment of ERCP skill appears to be feasible with a novel instrument that demonstrates favorable validity evidence. Future steps include determining whether the tool can discriminate between endoscopists of varying experience levels and predict important outcomes in clinical practice.

引用

页码：914 / 923

页数：10

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