Browsing by Subject "prostatectomy"

Now showing 1 - 3 of 3
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    An Assessment Tool to Provide Targeted Feedback to Robotic Surgical Trainees: Development and Validation of the End-to-End Assessment of Suturing Expertise (EASE)
    (American Urological Association, 2022-11) Haque, Taseen F.; Hui, Alvin; You, Jonathan; Ma, Runzhuo; Nguyen, Jessica H.; Lei, Xiaomeng; Cen, Steven; Aron, Monish; Collins, Justin W.; Djaladat, Hooman; Ghazi, Ahmed; Yates, Kenneth A.; Abreu, Andre L.; Daneshmand, Siamak; Desai, Mihir M.; Goh, Alvin C.; Hu, Jim C.; Lebastchi, Amir H.; Lendvay, Thomas S.; Porter, James; Schuckman, Anne K.; Sotelo, Rene; Sundaram, Chandru P.; Gill, Inderbir S.; Hung, Andrew J.; Urology, School of Medicine
    Purpose: To create a suturing skills assessment tool that comprehensively defines criteria around relevant sub-skills of suturing and to confirm its validity. Materials and Methods: 5 expert surgeons and an educational psychologist participated in a cognitive task analysis (CTA) to deconstruct robotic suturing into an exhaustive list of technical skill domains and sub-skill descriptions. Using the Delphi methodology, each CTA element was systematically reviewed by a multi-institutional panel of 16 surgical educators and implemented in the final product when content validity index (CVI) reached ≥0.80. In the subsequent validation phase, 3 blinded reviewers independently scored 8 training videos and 39 vesicourethral anastomoses (VUA) using EASE; 10 VUA were also scored using Robotic Anastomosis Competency Evaluation (RACE), a previously validated, but simplified suturing assessment tool. Inter-rater reliability was measured with intra-class correlation (ICC) for normally distributed values and prevalence-adjusted bias-adjusted Kappa (PABAK) for skewed distributions. Expert (≥100 prior robotic cases) and trainee (<100 cases) EASE scores from the non-training cases were compared using a generalized linear mixed model. Results: After two rounds of Delphi process, panelists agreed on 7 domains, 18 sub-skills, and 57 detailed sub-skill descriptions with CVI ≥ 0.80. Inter-rater reliability was moderately high (ICC median: 0.69, range: 0.51-0.97; PABAK: 0.77, 0.62-0.97). Multiple EASE sub-skill scores were able to distinguish surgeon experience. The Spearman’s rho correlation between overall EASE and RACE scores was 0.635 (p=0.003). Conclusions: Through a rigorous CTA and Delphi process, we have developed EASE, whose suturing sub-skills can distinguish surgeon experience while maintaining rater reliability.
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    Editorial Comment on END-2024-0124-OR.R1
    (Liebert, 2024-10) Bahler, Clinton D.; Urology, School of Medicine
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    Use of the cell cycle progression (CCP) score for predicting systemic disease and response to radiation of biochemical recurrence
    (IOS, 2016-07) Koch, Michael O.; Cho, Jane S.; Kaimakliotis, Hristos Z.; Cheng, Liang; Sangale, Zaina; Brawer, Michael; Welbourn, William; Reid, Julia; Stone, Steven; Department of Urology, IU School of Medicine
    BACKGROUND: Determining the optimal treatment for biochemical recurrence (BCR) after radical prostatectomy (RP) is challenging. OBJECTIVE: We evaluated the ability of CCP score (a prognostic RNA expression signature) to discriminate between systemic disease and local recurrence in patients with BCR after RP. METHODS: Sixty patients with BCR after RP were selected for analysis based on: 1) metastatic disease, 2) non-response to salvage external beam radiotherapy (EBRT), and 3) durable response to salvage EBRT. CCP scores were generated from the RNA expression of 46 genes. Logistic regression assessed the association between CCP score and patient group. RESULTS: Passing CCP scores were generated for 47 patients with complete clinical and pathologic data. CCP score predicted clinical status when comparing patients with metastatic disease or non-responders to salvage therapy to patients with durable response (p = 0.006). CCP score remained significantly predictive of clinical status after accounting for time to BCR, PSA level at BCR, and Gleason score (p = 0.0031). CONCLUSIONS: Elevated CCP score was associated with increased risk of systemic disease, indicating that CCP score may be useful in identifying patients with BCR who are most likely to benefit from salvage radiation therapy.