Validation of subjective rating scales for assessment of surgical workspace during laparoscopy

Background Recently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra‐abdominal pressure, level of muscle relaxation or body position, typically evaluated by surgeons using subjective rating scales. We aimed to validate two rating scales by having surgeons...

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Published in:	Acta anaesthesiologica Scandinavica Vol. 61; no. 10; pp. 1270 - 1277
Main Authors:	Nervil, G. G., Medici, R., Thomsen, J. L. D., Staehr‐Rye, A. K., Asadzadeh, S., Rosenberg, J., Gätke, M. R., Madsen, M. V.
Format:	Journal Article
Language:	English
Published:	England Wiley Subscription Services, Inc 01-11-2017
Subjects:	Adult Aged Aged, 80 and over Cholecystectomy, Laparoscopic Confidence intervals Female Humans Laparoscopy Male Medical personnel Middle Aged Muscle contraction Reliability analysis Reproducibility of Results Surgeons Surgery Workplace
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Abstract	Background Recently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra‐abdominal pressure, level of muscle relaxation or body position, typically evaluated by surgeons using subjective rating scales. We aimed to validate two rating scales by having surgeons assess surgical workspace in video sequences recorded during laparoscopic surgery. Method Video sequences were obtained from laparoscopic procedures. Eight experienced surgeons assessed the video sequences on a categorical 5‐point scale and a numerical 10‐point rating scale. Intraclass correlations coefficients (ICC) and 95% confidence intervals (CI) were calculated for intra‐ and inter‐rater reliability. Results The 5‐point rating scale had an intra‐rater ICC of 0.76 (0.69; 0.83) and an inter‐rater ICC of 0.57 (0.45; 0.68), corresponding to excellent and fair reliability, respectively. The 10‐point scale had an intra‐rater ICC of 0.86 (0.82; 0.89) and an inter‐rater ICC of 0.54 (0.39; 0.68), corresponding to excellent and fair as well. All surgeons used the full range of the 5‐point scale, but only one surgeon used the full range of the 10‐point scale. Conclusion In conclusion, both scales showed excellent intra‐rater and fair inter‐rater reliability for assessing surgical workspace in laparoscopy. The 5‐point surgical rating scale had all categories employed by all surgeons.
AbstractList	Background Recently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra-abdominal pressure, level of muscle relaxation or body position, typically evaluated by surgeons using subjective rating scales. We aimed to validate two rating scales by having surgeons assess surgical workspace in video sequences recorded during laparoscopic surgery. Method Video sequences were obtained from laparoscopic procedures. Eight experienced surgeons assessed the video sequences on a categorical 5-point scale and a numerical 10-point rating scale. Intraclass correlations coefficients (ICC) and 95% confidence intervals (CI) were calculated for intra- and inter-rater reliability. Results The 5-point rating scale had an intra-rater ICC of 0.76 (0.69; 0.83) and an inter-rater ICC of 0.57 (0.45; 0.68), corresponding to excellent and fair reliability, respectively. The 10-point scale had an intra-rater ICC of 0.86 (0.82; 0.89) and an inter-rater ICC of 0.54 (0.39; 0.68), corresponding to excellent and fair as well. All surgeons used the full range of the 5-point scale, but only one surgeon used the full range of the 10-point scale. Conclusion In conclusion, both scales showed excellent intra-rater and fair inter-rater reliability for assessing surgical workspace in laparoscopy. The 5-point surgical rating scale had all categories employed by all surgeons. Background Recently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra‐abdominal pressure, level of muscle relaxation or body position, typically evaluated by surgeons using subjective rating scales. We aimed to validate two rating scales by having surgeons assess surgical workspace in video sequences recorded during laparoscopic surgery. Method Video sequences were obtained from laparoscopic procedures. Eight experienced surgeons assessed the video sequences on a categorical 5‐point scale and a numerical 10‐point rating scale. Intraclass correlations coefficients (ICC) and 95% confidence intervals (CI) were calculated for intra‐ and inter‐rater reliability. Results The 5‐point rating scale had an intra‐rater ICC of 0.76 (0.69; 0.83) and an inter‐rater ICC of 0.57 (0.45; 0.68), corresponding to excellent and fair reliability, respectively. The 10‐point scale had an intra‐rater ICC of 0.86 (0.82; 0.89) and an inter‐rater ICC of 0.54 (0.39; 0.68), corresponding to excellent and fair as well. All surgeons used the full range of the 5‐point scale, but only one surgeon used the full range of the 10‐point scale. Conclusion In conclusion, both scales showed excellent intra‐rater and fair inter‐rater reliability for assessing surgical workspace in laparoscopy. The 5‐point surgical rating scale had all categories employed by all surgeons. Recently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra-abdominal pressure, level of muscle relaxation or body position, typically evaluated by surgeons using subjective rating scales. We aimed to validate two rating scales by having surgeons assess surgical workspace in video sequences recorded during laparoscopic surgery. Video sequences were obtained from laparoscopic procedures. Eight experienced surgeons assessed the video sequences on a categorical 5-point scale and a numerical 10-point rating scale. Intraclass correlations coefficients (ICC) and 95% confidence intervals (CI) were calculated for intra- and inter-rater reliability. The 5-point rating scale had an intra-rater ICC of 0.76 (0.69; 0.83) and an inter-rater ICC of 0.57 (0.45; 0.68), corresponding to excellent and fair reliability, respectively. The 10-point scale had an intra-rater ICC of 0.86 (0.82; 0.89) and an inter-rater ICC of 0.54 (0.39; 0.68), corresponding to excellent and fair as well. All surgeons used the full range of the 5-point scale, but only one surgeon used the full range of the 10-point scale. In conclusion, both scales showed excellent intra-rater and fair inter-rater reliability for assessing surgical workspace in laparoscopy. The 5-point surgical rating scale had all categories employed by all surgeons. BACKGROUNDRecently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra-abdominal pressure, level of muscle relaxation or body position, typically evaluated by surgeons using subjective rating scales. We aimed to validate two rating scales by having surgeons assess surgical workspace in video sequences recorded during laparoscopic surgery.METHODVideo sequences were obtained from laparoscopic procedures. Eight experienced surgeons assessed the video sequences on a categorical 5-point scale and a numerical 10-point rating scale. Intraclass correlations coefficients (ICC) and 95% confidence intervals (CI) were calculated for intra- and inter-rater reliability.RESULTSThe 5-point rating scale had an intra-rater ICC of 0.76 (0.69; 0.83) and an inter-rater ICC of 0.57 (0.45; 0.68), corresponding to excellent and fair reliability, respectively. The 10-point scale had an intra-rater ICC of 0.86 (0.82; 0.89) and an inter-rater ICC of 0.54 (0.39; 0.68), corresponding to excellent and fair as well. All surgeons used the full range of the 5-point scale, but only one surgeon used the full range of the 10-point scale.CONCLUSIONIn conclusion, both scales showed excellent intra-rater and fair inter-rater reliability for assessing surgical workspace in laparoscopy. The 5-point surgical rating scale had all categories employed by all surgeons.
Author	Thomsen, J. L. D. Nervil, G. G. Staehr‐Rye, A. K. Rosenberg, J. Medici, R. Asadzadeh, S. Gätke, M. R. Madsen, M. V.
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Cites_doi	10.1007/s00464-014-3711-7 10.1037/1040-3590.7.3.309 10.1097/EJA.0000000000000094 10.1213/ANE.0000000000000316 10.1007/s00404-014-3494-z 10.1037/1040-3590.6.4.284 10.1111/aas.12419 10.1177/001316447303300309 10.1093/bja/aet377 10.1046/j.1365-2044.2003.03150.x 10.1191/0962280204sm365ra 10.1213/ane.0b013e3181b0826a 10.1097/00000542-200012000-00008 10.1093/bja/aew114
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Notes	https://clinicaltrials.gov/ct2/show/NCT02545270?term=NCT02545270&rank=1 The study was supported in part by a research grant from Investigator‐Initiated Studies Program of MSD. The opinions expressed in this study are those of the authors and do not necessarily represent those of MSD. Clinical Trial Registration Conflict of Interest Dr. Nervil reports grants from Merck Sharp & Dohme Corp during the conduct of the study. Dr. Medici reports grants from Merck Sharp & Dohme Corp during the conduct of the study and grants from Merck Sharp & Dohme Corp outside the submitted work. Dr. Thomsen reports grants from Merck Sharpe and Dohme outside the submitted work. Dr. Staehr‐Rye reports grants from Merck Sharp & Dohme Corp during the conduct of the study. Dr. Asadzadeh has nothing to disclose. Dr. Rosenberg reports personal fees from Merck and grants and personal fees from Bard outside the submitted work. Dr. Gätke reports grants from Merck Sharp & Dohme Corp during the conduct of the study. Dr. Vested Madsen reports grants from Merck Sharp & Dohme Corp during the conduct of the study and grants from Merck Sharp & Dohme Corp outside the submitted work. Funding ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
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Snippet	Background Recently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra‐abdominal pressure, level of muscle relaxation... Recently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra-abdominal pressure, level of muscle relaxation or body... Background Recently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra-abdominal pressure, level of muscle relaxation... BACKGROUNDRecently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra-abdominal pressure, level of muscle relaxation...
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SubjectTerms	Adult Aged Aged, 80 and over Cholecystectomy, Laparoscopic Confidence intervals Female Humans Laparoscopy Male Medical personnel Middle Aged Muscle contraction Reliability analysis Reproducibility of Results Surgeons Surgery Workplace
Title	Validation of subjective rating scales for assessment of surgical workspace during laparoscopy
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