Evidence map›Paper›PMID 38332173›Full record

ArticleSurgical endoscopy2024

Development and preliminary validation of a new task-based objective procedure-specific assessment of inguinal hernia repair procedural safety.

Vahagn C Nikolian, Diego Camacho, David Earle, Ryan Lehmann, Peter Nau, Bruce Ramshaw, Jonah Stulberg

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Competency Assessment in Training in African Countries.Journal of abdominal wall surgery : JAWS · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Vahagn C NikolianDepartment of Surgery, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Rd., Portland, OR, 97239, USA. nikolian@ohsu.edu.
Diego CamachoMinimally Invasive and Endoscopic Surgery at Montefiore Medical Center, New York, NY, USA.
David EarleNew England Hernia Center, Lowell, MA, USA.
Ryan LehmannDepartment of Surgery, Section of Bariatric Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA, USA.
Peter NauDepartment of Surgery, Section of Bariatric Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA, USA.
Bruce RamshawCQInsights PBC, Knoxville, TN, USA.
Jonah StulbergDepartment of Surgery, McGovern Medical School University of Texas Health Science Center at Houston, Houston, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgical videos coupled with structured assessments enable surgical training programs to provide independent competency evaluations and align with the American Board of Surgery's entrustable professional activities initiative. Existing assessment instruments for minimally invasive inguinal hernia repair (IHR) have limitations with regards to reliability, validity, and usability. A cross-sectional study of six surgeons using a novel objective, procedure-specific, 8-item competency assessment for minimally invasive inguinal hernia repair (IHR-OPSA) was performed to assess inter-rater reliability using a "safe" vs. "unsafe" scoring rubric.

methodsThe IHR-OPSA was developed by three expert IHR surgeons, field tested with five IHR surgeons, and revised based upon feedback. The final instrument included: (1) incision/port placement; (2) dissection of peritoneal flap (TAPP) or dissection of peritoneal flap (TEP); (3) exposure; (4) reducing the sac; (5) full dissection of the myopectineal orifice; (6) mesh insertion; (7) mesh fixation; and (8) operation flow. The IHR-OPSA was applied by six expert IHR surgeons to 20 IHR surgical videos selected to include a spectrum of hernia procedures (15 laparoscopic, 5 robotic), anatomy (14 indirect, 5 direct, 1 femoral), and Global Case Difficulty (easy, average, hard). Inter-rater reliability was assessed against Gwet's AC

resultsThe IHR-OPSA inter-rater reliability was good to excellent, ranging from 0.65 to 0.97 across the eight items. Assessments of robotic procedures had higher reliability with near perfect agreement for 7 of 8 items. In general, assessments of easier cases had higher levels of agreement than harder cases.

conclusionsA novel 8-item minimally invasive IHR assessment tool was developed and tested for inter-rater reliability using a "safe" vs. "unsafe" rating system with promising results. To promote instrument validity the IHR-OPSA was designed and evaluated within the context of intended use with iterative engagement with experts and testing of constructs against real-world operative videos.

Indexed as

Hernia, InguinalLaparoscopyRobotic Surgical ProceduresCross-Sectional StudiesHerniorrhaphyHumansReproducibility of ResultsSurgical MeshEntrustable professional activitiesHernia surgeryMinimally invasive inguinal hernia repairObjective procedure-specific assessmentSurgical trainingVideo-based assessment

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.