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. 2021 Jul;35(7):1833-1849.
doi: 10.1038/s41433-021-01463-8. Epub 2021 Mar 1.

Validity of scoring systems for the assessment of technical and non-technical skills in ophthalmic surgery-a systematic review

Thomas Charles Wood  1 , Sundas Maqsood  2 , Mayank A Nanavaty  2   3 , Saul Rajak  2   3
Affiliations

Validity of scoring systems for the assessment of technical and non-technical skills in ophthalmic surgery-a systematic review

Thomas Charles Wood et al. Eye (Lond). 2021 Jul.

Abstract
in English, Chinese

Evaluation and recommendation of the scoring systems for technical skills (TS) and non-technical skills (NTS) assessments in ophthalmic surgery. A literature search was performed between December 2019 and May 2020. Studies describing the development or validation of TS or NTS scoring systems in ophthalmic surgery were included. Only scoring systems for completion by hand were included. The primary outcome was the validity and reliability status for each scoring system. The secondary outcome was recommendation based on modified Oxford Centre for Evidence-Based Medicine guidelines. Nineteen and five scoring systems were identified for TS and NTS respectively. TS scoring systems exist for cataract surgery (including the steps of phacoemulsification and paediatric cataract surgery) ptosis, strabismus, lateral tarsal strip, vitrectomy, and intraocular surgery in general. NTS scoring systems apply to cataract surgery or ophthalmic surgery in general. No single scoring system satisfied all validity and reliability measures. The recommended TS scoring systems are 'International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubrics' (ICO-OSCAR) for phacoemulsification, strabismus and paediatric cataract surgery, and 'Objective Structured Assessment of Cataract Surgical Skill' (OSACSS). Non-Technical Skills for Surgeons (NOTSS), Observational Teamwork Assessment for Surgery (OTAS) and Anaesthetists Non-Technical Skills (ANTS) are recommended for NTS. There is a paucity of NTS scoring systems. Further research is required to validate all scoring systems to consistent standards. Limitations of the assessment tools included infrequent quantification of face and content validity, and inconsistency in terminology and statistical methods between studies.

摘要: 概述、评估和推荐眼科手术技能 (TS) 和非技能 (NTS) 的评分系统。我们对发表于2019年12月至2020年5月期间内的文献进行了检索。其中描述眼科手术TS或NTS评分系统发展或评估的研究被初步纳入。最终只保留手动评分系统的文章。本文的主要临床结局为各评分系统的有效性和可靠性。次要结局为基于牛津循证医学中心修订指南的建议。TS和NTS分别有19和5个评分系统。TS评分系统适用于白内障手术 (包括超声乳化和儿童白内障手术) 、上睑下垂、斜视、睑板外侧条形剥离术、玻璃体切除术和一般的眼科手术。NTS评分系统一般适用于其他普通的白内障手术或眼科手术。没有一个的评分系统能满足所有的有效性和可靠性标准。本文推荐的TS评分系统为“国际眼科理事会的眼科手术能力评估标准”(ICO-OSCAR), 一般用于白内障超声乳化、斜视和儿科白内障手术, 以及“白内障手术技能的客观评估”(OSACSS)。推荐的NTS评分系统为“外科医生的非技能评估” (NOTSS) 、“手术的观察性团队评估” (OTAS) 和“麻醉师非技能评估” (ANTS) 。NTS评分系统很少。未来需要进一步研究来验证所有的评分系统是否符合统一的标准。评分系统的局限性包括: 表面和内在的有效性经常不被量化, 以及不同研究的术语和统计方法不一致。.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Flow chart of study selection.
Flow chart of article identification, article exclusion, full text review, and article inclusion.
See this image and copyright information in PMC

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