Evidence map›Paper›PMID 38470307›Full record

ArticleThe Laryngoscope2024

Correcting for Rater Effects in Operating Room Surgical Skills Assessment.

Ryan Chou, Hajira Naz, Kofi D O Boahene, Jessica H Maxwell, John R Wanamaker, Patrick J Byrne, Ira D Papel, Theda C Kontis, Gregory D Hager, Lisa E Ishii and 3 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Laryngoscope, 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
0.6field-weighted citation impact, top 37% of its field
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 citations in OpenAlex.

  1. 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

13 authors at 4 institutions in 1 country.

Ryan ChouDepartment of Biomedical Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland, U.S.A.ORCID 0009-0000-8520-0404
Hajira NazDugoni School of Dentistry, University of Pacific, San Francisco, California, U.S.A.
Kofi D O BoaheneDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.ORCID 0000-0002-4924-7560
Jessica H MaxwellDepartment of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, U.S.A.
John R WanamakerDepartment of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, U.S.A.
Patrick J ByrneHead and Neck Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
Ira D PapelDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
Theda C KontisDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
Gregory D HagerMalone Center for Engineering in Healthcare, Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland, U.S.A.
Lisa E IshiiDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
Sonya MalekzadehDepartment of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, U.S.A.
S Swaroop VedulaMalone Center for Engineering in Healthcare, Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland, U.S.A.
Masaru IshiiDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
Johns Hopkins University · USGeorgetown University · USCleveland Clinic · USUniversity of the Pacific · US

Funding

Objective assessment of surgical competence in a septoplasty modelR01DE025265 · NIDCR · JOHNS HOPKINS UNIVERSITY · PI ISHII, MASARU · 2015 to 2019
$2.6M
National Institute of Dental & Craniofacial Research of the National Institutes of Health R01DE025265NIDCR NIH HHS R01 DE025265Provost Undergraduate Research Award from Johns Hopkins University
6 · The paper itself

Abstract

objectiveTo estimate and adjust for rater effects in operating room surgical skills assessment performed using a structured rating scale for nasal septoplasty.

methodsWe analyzed survey responses from attending surgeons (raters) who supervised residents and fellows (trainees) performing nasal septoplasty in a prospective cohort study. We fit a structural equation model with the rubric item scores regressed on a latent component of skill and then fit a second model including the rating surgeon as a random effect to model a rater-effects-adjusted latent surgical skill. We validated this model against conventional measures including the level of expertise and post-graduation year (PGY) commensurate with the trainee's performance, the actual PGY of the trainee, and whether the surgical goals were achieved.

resultsOur dataset included 188 assessments by 7 raters and 41 trainees. The model with one latent construct for surgical skill and the rater as a random effect was the best. Rubric scores depended on how severe or lenient the rater was, sometimes almost as much as they depended on trainee skill. Rater-adjusted latent skill scores increased with attending-estimated skill levels and PGY of trainees, increased with the actual PGY, and appeared constant over different levels of achievement of surgical goals.

conclusionOur work provides a method to obtain rater effect adjusted surgical skill assessments in the operating room using structured rating scales. Our method allows for the creation of standardized (i.e., rater-effects-adjusted) quantitative surgical skill benchmarks using national-level databases on trainee assessments. LEVEL OF EVIDENCE: N/A Laryngoscope, 134:3548-3554, 2024.

Indexed as

Clinical CompetenceInternship and ResidencyOperating RoomsFemaleHumansMaleNasal SeptumProspective StudiesRhinoplastySurgeonsSurveys and QuestionnairesOSATSrater biasrater effectseptoplastySGATsurgical skill assessment

Identifiers

PMID38470307
PMCPMC11245371
OpenAlexW4392715916

What OpenQuestion holds

Textmetadata
LicenceTDM
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.