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Assessment of the Interrater Reliability of the Congress of Neurological Surgeons Microanastomosis Assessment Scale.

ABSTRACT: BACKGROUND:The potential for simulation-based learning in neurosurgical training has led the Congress of Neurosurgical Surgeons to develop a series of simulation modules. The Northwestern Objective Microanastomosis Assessment Tool (NOMAT) was created as the corresponding assessment tool for the Congress of Neurosurgical Surgeons Microanastomosis Module. The face and construct validity of the NOMAT have been previously established. OBJECTIVE:To further validate the NOMAT by determining its interrater reliability (IRR) between raters of varying levels of microsurgical expertise. METHODS:The NOMAT was used to assess residents' performance in a microanastomosis simulation module in 2 settings: Northwestern University and the Society of Neurological Surgeons 2014 Boot Camp at the University of Indiana. At Northwestern University, participants were scored by 2 experienced microsurgeons. At the University of Indiana, participants were scored by 2 postdoctoral fellows and an experienced microsurgeon. The IRR of NOMAT was estimated by computing the intraclass correlation coefficient using SPSS v22.0 (IBM, Armonk, New York). RESULTS:A total of 75 residents were assessed. At Northwestern University, 21 residents each performed microanastomosis on 2 model vessels of different sizes, one 3 mm and one 1 mm. At the University of Indiana, 54 residents performed a single microanastomosis procedure on 3-mm vessels. The intraclass correlation coefficient of the total NOMAT scores was 0.88 at Northwestern University and 0.78 at the University of Indiana. CONCLUSION:This study indicates high IRR for the NOMAT. These results suggest that the use of raters with varying levels of expertise does not compromise the precision or validity of the scale. This allows for a wider adoption of the scale and, hence, a greater potential educational impact.

SUBMITTER: Pines AR

PROVIDER: S-EPMC6312083 | biostudies-other | 2017 Feb

REPOSITORIES: biostudies-other

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Assessment of the Interrater Reliability of the Congress of Neurological Surgeons Microanastomosis Assessment Scale.

Pines Andrew R AR Alghoul Mohammed S MS Hamade Youssef J YJ Sattur Mithun G MG Aoun Rami James N RJN Halasa Tariq K TK Krishna Chandan C Zammar Samer G SG El Tecle Najib E NE El Ahmadieh Tarek Y TY Aoun Salah G SG Byrne Richard W RW Harrop James S JS Ragel Brian T BT Resnick Daniel K DK Lonser Russell R RR Selden Nathan R NR Bendok Bernard R BR

Operative neurosurgery (Hagerstown, Md.) 20170201 1

<h4>Background</h4>The potential for simulation-based learning in neurosurgical training has led the Congress of Neurosurgical Surgeons to develop a series of simulation modules. The Northwestern Objective Microanastomosis Assessment Tool (NOMAT) was created as the corresponding assessment tool for the Congress of Neurosurgical Surgeons Microanastomosis Module. The face and construct validity of the NOMAT have been previously established.<h4>Objective</h4>To further validate the NOMAT by determi ...[more]

PMID: 28931262

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Project description:BackgroundThe aims of this study were to investigate the role of the Neurological Assessment of Neuro-Oncology (NANO) scale in predicting the prognosis of patients with glioblastoma, and compare these results to predicted data of the Karnofsky Performance Scale (KPS), and Eastern Cooperative Oncology Group (ECOG)/World Health Organization (WHO) performance status. Additionally, we examined other prognostic factors in glioblastoma patients.MethodsThe medical records of 76 patients with a new diagnosis of histologically ascertained glioblastoma in the period from January 2002 to December 2015 at the authors' institution were retrospectively reviewed. Clinical factors, including epidemiologic, radiologic, and therapeutic values were reviewed as well as the performance status assessed by the KPS, ECOG/WHO performance status, and NANO scale.ResultsThe mean overall survival was 19.8 months (95% confidence interval 15.2-25.4 months). At initial diagnosis, the mean value [±standard deviation (SD)] of KPS score, ECOG/WHO performance status, and NANO scale were 81 (±7.4), 1.3 (±0.6), and 7.3 (±3.8), respectively. Multivariate analysis for predicting survival showed odds ratios of KPS score, ECOG/WHO performance status, and NANO scale were 2.502 (≥80 vs. <80; p=0.024), 1.691 (0-1 vs. 2-5; p=0.047), and 2.763 (0-7 vs. 8-23; p=0.020), respectively. At the time of progression, the mean value (±SD) of KPS score, ECOG/WHO performance status, and NANO scale were 69 (±8.2), 1.6 (±0.7), and 11.4 (±4.2), respectively; multivariate analysis for predicting survival showed that the odd ratios for KPS score, ECOG/WHO performance status, and NANO scale were 2.007 (≥80 vs. <80; p=0.035), 1.321 (0-1 vs. 2-5; p=0.143), and 3.182 (0-7 vs. 8-23; p=0.002), respectively.ConclusionThe NANO scale provided a more detailed and objective measure of neurologic function than that currently used for predicting the prognosis of glioblastoma patients, especially at the time of progression.

Project description:BackgroundThe Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool which is capable of both identifying the priorities of the individual patient and measuring the outcomes relevant to him/her, resulting in a Patient Benefit Index (PBI) with range 0-3, indicating how much benefit the patient had experienced from the admission. The aim of this study was to evaluate the reliability, validity, responsiveness and interpretability of the P-BAS HOP.MethodsA longitudinal study among hospitalised older patients with a baseline interview during hospitalisation and a follow-up by telephone 3 months after discharge. Test-retest reliability of the baseline and follow-up questionnaire were tested. Percentage of agreement, Cohen's kappa with quadratic weighting and maximum attainable kappa were calculated per item. The PBI was calculated for both test and retest of baseline and follow-up and compared with Intraclass Correlation Coefficient (ICC). Construct validity was tested by evaluating pre-defined hypotheses comparing the priority of goals with experienced symptoms or limitations at admission and the achievement of goals with progression or deterioration of other constructs. Responsiveness was evaluated by correlating the PBI with the anchor question 'How much did you benefit from the admission?'. This question was also used to evaluate the interpretability of the PBI with the visual anchor-based minimal important change distribution method.ResultsReliability was tested with 53 participants at baseline and 72 at follow-up. Mean weighted kappa of the baseline items was 0.38. ICC between PBI of the test and retest was 0.77. Mean weighted kappa of the follow-up items was 0.51. ICC between PBI of the test and retest was 0.62. For the construct validity, tested in 451 participants, all baseline hypotheses were confirmed. From the follow-up hypotheses, tested in 344 participants, five of seven were confirmed. The Spearman's correlation coefficient between the PBI and the anchor question was 0.51. The optimal cut-off point was 0.7 for 'no important benefit' and 1.4 points for 'important benefit' on the PBI.ConclusionsAlthough the concept seems promising, the reliability and validity of the P-BAS HOP appeared to be not yet satisfactory. We therefore recommend adapting the P-BAS HOP.

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Assessment of the Interrater Reliability of the Congress of Neurological Surgeons Microanastomosis Assessment Scale.

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Assessment of the Interrater Reliability of the Congress of Neurological Surgeons Microanastomosis Assessment Scale.

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