Mp33-06 Association Between Crowd-Sourced Assessment of Technical Skills (Csats Tm ) and Complications Following Radical Prostatectomy

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety II (MP33)1 May 2024MP33-06 ASSOCIATION BETWEEN CROWD-SOURCED ASSESSMENT OF TECHNICAL SKILLS (CSATSTM) AND COMPLICATIONS FOLLOWING RADICAL PROSTATECTOMY Maximilian J. Rabil, Michael Jalfon, Dylan Heckscher, Zhiqian Song, Fangyong Li, Michael S. Leapman, and Jaime A. Cavallo Maximilian J. RabilMaximilian J. Rabil , Michael JalfonMichael Jalfon , Dylan HeckscherDylan Heckscher , Zhiqian SongZhiqian Song , Fangyong LiFangyong Li , Michael S. LeapmanMichael S. Leapman , and Jaime A. CavalloJaime A. Cavallo View All Author Informationhttps://doi.org/10.1097/01.JU.0001009520.30626.80.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Crowd-Sourced Assessment of Technical Skills (CSATSTM) was developed to provide a practical and cost-efficient means of evaluating surgeons' technical skill. We hypothesized that implementation of CSATSTM and local peer review of surgical videos would improve surgeons' Global Evaluative Assessment of Robotic Skills (GEARS) scores and patient outcomes for robotic-assisted laparoscopic prostatectomy (RALP). METHODS: 5 fellowship-trained urologists submitted the vesicourethral anastomosis (VUA) video segment from RALPs performed at a major academic medical center for anonymized CSATSTM GEARS scoring and external expert narrative review between April 2022-April 2023. Surgeons also participated in local peer review of the VUA video segments. Temporal trend of GEARS scores and changes in postoperative outcomes over the 12-month period before and after implementation of CSATS program were analyzed using regression models. Sensitivity analyses using Wilcoxon rank-sum tests to compare surgeon-selected cases to randomly-selected cases were performed to assess for selection bias. Significance was set at p<0.05. RESULTS: There were no statistically significant differences in GEARS scores for randomly-selected compared to surgeon-selected cases. GEARS score positively correlated with annual surgical RALP volume (r=0.39, p=0.003) and negatively correlated with years in practice (r=-0.34, p=0.01). When adjusting for relevant patient variables, 1 surgeon had a statistically significant improvement in GEARS Score (0.1±0.04/month, p=0.05). Likelihood of sepsis (OR 0.07, CI 0.01-1.00, p=0.05) and pelvic fluid collection (OR 0.09, CI 0.01-0.99, p=0.049) were significantly decreased in the 12 months during the intervention (n=165) compared to the prior 12 months (n=144) after adjusting for confounders. No complication increased in frequency during the intervention period. CONCLUSIONS: CSATSTM evaluation and local surgical video peer review of RALP VUA segments correlates with reduction in VUA-relevant postoperative complications. This supports the utility of surgical skill assessments for practicing surgeons in achieving clinically-meaningful surgical outcome improvements. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e562 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Maximilian J. Rabil More articles by this author Michael Jalfon More articles by this author Dylan Heckscher More articles by this author Zhiqian Song More articles by this author Fangyong Li More articles by this author Michael S. Leapman More articles by this author Jaime A. Cavallo More articles by this author Expand All Advertisement PDF downloadLoading ...