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Currently submitted to: JMIR Research Protocols

Date Submitted: Jul 22, 2020
Open Peer Review Period: Jul 22, 2020 - Sep 16, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Novel Assessments of Technical and Non-Technical Cardiac Surgery Quality: Protocol for a Mixed Methods Study

ABSTRACT

Background:

Of the 150,000 patients annually undergoing coronary artery bypass grafting surgery, 35% develop complications that increase mortality 5-fold and expenditures by 50%. Differences in patient risk and operative approach explain only 2% of hospital variation in some complications. The intraoperative phase remains understudied as a source of variation, despite its complexity and amenability to improvement.

Objective:

The objectives of this study are to: (i) investigate the relationship between peer assessments of intraoperative technical skills and non-technical practices with risk-adjusted complication rates and (ii) evaluate the feasibility of using computer-based metrics to automate the assessment of important intraoperative technical skills and non-technical practices.

Methods:

This multi-center study will use video-recording, established peer assessment tools, electronic health record data, registry data and a high-dimensional computer vision approach to: (1) investigate the relationship between peer assessments of surgeon technical skills and variability in risk-adjusted patient adverse events; (2) investigate the relationship between peer assessments of intraoperative team-based non-technical practices and variability in risk-adjusted patient adverse events; (3) use quantitative and qualitative methods to explore the feasibility of using objective, data-driven computer-based assessments to automate the measurement of significant, intraoperative determinants of risk-adjusted patient adverse events.

Results:

The project was funded by the National Heart, Lung and Blood Institute in 2019 and enrollment for the overall project is expected to begin in 2020.

Conclusions:

We anticipate this project will substantially increase our ability to assess determinants of variation in complication rates by specifically studying a surgeon’s technical skills and operating room team member non-technical practices. These findings may provide effective targets for future trials or quality improvement initiatives to enhance the quality and safety of cardiac surgical patient care. Clinical Trial: -


 Citation

Please cite as:

Novel Assessments of Technical and Non-Technical Cardiac Surgery Quality: Protocol for a Mixed Methods Study

JMIR Preprints. 22/07/2020:22536

DOI: 10.2196/preprints.22536

URL: https://preprints.jmir.org/preprint/22536

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