Mp16-16 evaluation of peer-rated surgical skill and muscle sampling in transurethral resection of bladder tumor

You have accessJournal of UrologyBladder Cancer: Non-invasive II (MP16)1 Sep 2021MP16-16 EVALUATION OF PEER-RATED SURGICAL SKILL AND MUSCLE SAMPLING IN TRANSURETHRAL RESECTION OF BLADDER TUMOR Minh Pham, Oliver Ko, Reiping Huang, Amanda Vo, Kyle Tsai, Jeremy Lai, Matthew Hudnall, Joshua Halpern, Joshua Meeks, Jonas Benson, Ricardo Soares, Ronald Kim, Jonah Stulberg, and Gregory Auffenberg Minh PhamMinh Pham More articles by this author , Oliver KoOliver Ko More articles by this author , Reiping HuangReiping Huang More articles by this author , Amanda VoAmanda Vo More articles by this author , Kyle TsaiKyle Tsai More articles by this author , Jeremy LaiJeremy Lai More articles by this author , Matthew HudnallMatthew Hudnall More articles by this author , Joshua HalpernJoshua Halpern More articles by this author , Joshua MeeksJoshua Meeks More articles by this author , Jonas BensonJonas Benson More articles by this author , Ricardo SoaresRicardo Soares More articles by this author , Ronald KimRonald Kim More articles by this author , Jonah StulbergJonah Stulberg More articles by this author , and Gregory AuffenbergGregory Auffenberg More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002001.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prior work has shown that detrusor muscle sampling (MS) from transurethral resection of bladder tumor (TURBT) is related to oncologic outcomes. It is unknown if surgeon skill can be assessed with operative videos or if skill is associated with MS. We aim to assess the reliability of peer review of TURBT videos to quantify skill and whether skill is associated with MS. METHODS: Urologists from our health system were recruited to submit a TURBT video. Each was rated by blinded peer surgeons using a structured scoring instrument. Interrater reliability (IRR) was determined for each domain on the instrument (Table 1). Items with IRR ≥0.4 were used to generate a normalized composite skill score. Using retrospective data, we measured surgeon MS rates for TURBTs performed from 9/2018 to 9/2019. A random-intercept logistic regression model was fit, adjusting for surgeon and non-surgeon factors to assess the relationship between surgical skill and MS. RESULTS: 13 surgeons submitted a TURBT video, each reviewed by 10 raters. Of 10 domains assessed, 6 had IRR ≥0.4 and were used for a composite skill score (Table 1). Normalized composite skill score varied significantly among surgeons (Figure 1). With data from 228 TURBTs by 8 surgeons with >5 cases, the overall MS rate was 72%, varying from 50% to 90% across surgeons. Regression modeling showed an association between sending a separate deep sample to pathology and MS (odds ratio [OR]: 1.97; 95% confidence interval [CI]: 1.02 – 3.81; p=0.045) but not between peer-rated skill and MS (OR: 0.81; 95% CI: 0.57 – 1.17; p=0.191; Table 2). CONCLUSIONS: Video-based peer review is a mechanism to assess TURBT performance, with modest IRR and significant variation in skill across surgeons. Surgeon skill was not associated with MS in TURBT. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e303-e304 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Minh Pham More articles by this author Oliver Ko More articles by this author Reiping Huang More articles by this author Amanda Vo More articles by this author Kyle Tsai More articles by this author Jeremy Lai More articles by this author Matthew Hudnall More articles by this author Joshua Halpern More articles by this author Joshua Meeks More articles by this author Jonas Benson More articles by this author Ricardo Soares More articles by this author Ronald Kim More articles by this author Jonah Stulberg More articles by this author Gregory Auffenberg More articles by this author Expand All Advertisement PDF downloadLoading ...