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Assessment of Competence in EVAR Procedures: A Novel Rating Scale Developed by the Delphi Technique.
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2017 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 54, no 1, p. 34-41, article id S1078-5884(17)30219-8Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE/BACKGROUND: To develop a procedure specific global rating scale for assessment of operator competence in endovascular aortic repair (EVAR).

METHODS: A Delphi approach was used to achieve expert consensus. A panel of 32 international experts (median 300 EVAR procedures, range 200-3000) from vascular surgery (n = 21) and radiology (n = 11) was established. The first Delphi round was based on a review of endovascular skills assessment papers, stent graft instructions for use, and structured interviews. It led to a primary pool of 83 items that were formulated as global rating scale items with tentative anchors. Iterative Delphi rounds were executed. The panellists rated the importance of each item on a 5 point Likert scale. Consensus was defined as 80% of the panel rating an item 4 or 5 in the primary round and 90% in subsequent rounds. Consensus on the final assessment tool was defined as Cronbach's alpha > .8 after a minimum of three rounds.

RESULTS: Thirty-two of 35 invited experts participated. Three rounds of surveys were completed with a completion rate of 100% in the first two rounds and 91% in round three. The 83 primary assessment items were supplemented with five items suggested by the panel and reduced to seven pivotal assessment items that reached consensus, Cronbach's alpha = 0.82. The seven item rating scale covers key elements of competence in EVAR stent placement and deployment. Each item has well defined grades with explicit anchors at unacceptable, acceptable, and superior performance on a 5 point Likert scale.

CONCLUSION: The Delphi methodology allowed for international consensus on a new procedure specific global rating scale for assessment of competence in EVAR. The resulting scale, EndoVascular Aortic Repair Assessment of Technical Expertise (EVARATE), represents key elements in the procedure. EVARATE constitutes an assessment tool for providing structured feedback to endovascular operators in training.

Place, publisher, year, edition, pages
2017. Vol. 54, no 1, p. 34-41, article id S1078-5884(17)30219-8
Keyword [en]
Abdominal aortic aneurysm, Clinical competence, Delphi technique, EVAR, Educational assessment, Endovascular procedures
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-336072DOI: 10.1016/j.ejvs.2017.04.001PubMedID: 28549712OAI: oai:DiVA.org:uu-336072DiVA: diva2:1164879
Note

Collaborators (32)

Aho P, Back M, Bicknell C, Björses K, Brunkwall J, Dake M, Dias N, Dorenberg E, Duvnjak S, Falkenberg M, Formgren J, Holst J, Kristmundsson T, Langfeldt S, Lindgren H, Mafi H, Malina M, Mani K, Modarai B, Morgan R, Nyman N, Pärsson H, Rasmussen J, Resch T, Shames M, Van Den Berg JC, Van Herzeele I, Verhagen H, Verhoeven E, Venermo M, Vermassen F, Wanhainen A.

Kevin Mani och Anders Wanhainen är med som collaborators, de arbetar på Institutionen för kirurgiska vetenskapet på Uppsala universitet, inom kärlkirurgi

Available from: 2017-12-12 Created: 2017-12-12 Last updated: 2017-12-12

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