Key result
Reporting of the learning curve in 68 prospective TAVI studies was relatively poor, with only 54% addressing it, 12% mentioning a roll-in period, and 4% disclosing proctorship.
Why the study?
TAVI requires technical expertise, but the quality of information reported about the procedural learning curve in prospective clinical studies was unclear.
Systematic Review (n=68)
Despite being a core component of successful TAVI procedures, the quality of information reported about the learning curve in prospective studies is poor and lacks uniform guidance.
Answers are grounded in this paper and cite their sources.
Inadequate TAVI learning-curve reporting in prospective studies limits generalizability; leaves open standardized training benchmarks for new centers.
BACKGROUND: Transcatheter aortic-valve implantation (TAVI) has become an essential alternative to surgical aortic-valve replacement in the treatment of symptomatic severe aortic stenosis, and this procedure requires technical expertise. The aim of this study was to identify prospective studies on TAVI from the past 10 years, and then to analyze the quality of information reported about the learning curve. MATERIALS AND METHODS: A systematic review of articles published between 2007 and 2017 was performed using PubMed and the EMBASE database. Prospective studies regarding TAVI were included. The quality of information reported about the learning curve was evaluated using the following criteria: mention of the learning curve, the description of a roll-in phase, the involvement of a proctor, and the number of patients suggested to maintain skills. RESULTS: A total of sixty-eight studies met the selection criteria and were suitable for analysis. The learning curve was addressed in approximately half of the articles (n = 37, 54 percent). However, the roll-in period was mentioned by only eight studies (12 percent) and with very few details. Furthermore, a proctorship was disclosed in three articles (4 percent) whereas twenty-five studies (37 percent) included authors that were proctors for manufacturers of TAVI. CONCLUSION: Many prospective studies on TAVI over the past 10 years mention learning curves as a core component of successful TAVI procedures. However, the quality of information reported about the learning curve is relatively poor, and uniform guidance on how to properly assess the learning curve is still missing.
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Thivilliers et al. (2020) conducted a systematic review in Symptomatic severe aortic stenosis (n=68). Reporting of the learning curve in TAVI studies was evaluated on Quality of information reported about the learning curve (mention of learning curve, roll-in phase, proctor involvement). Reporting of the learning curve in 68 prospective TAVI studies was relatively poor, with only 54% addressing it, 12% mentioning a roll-in period, and 4% disclosing proctorship.
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