RT Journal Article
SR Electronic
T1 Development of a surgical competency assessment tool for sentinel lymph node dissection by minimally invasive surgery for endometrial cancer
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP ijgc-2020-002315
DO 10.1136/ijgc-2020-002315
A1 Kristen Moloney
A1 Monika Janda
A1 Michael Frumovitz
A1 Mario Leitao
A1 Nadeem R Abu-Rustum
A1 Emma Rossi
A1 James L Nicklin
A1 Marie Plante
A1 Fabrice R Lecuru
A1 Alessandro Buda
A1 Andrea Mariani
A1 Yee Leung
A1 Sarah Elizabeth Ferguson
A1 Rene Pareja
A1 Rainer Kimmig
A1 Pearl Shuang Ye Tong
A1 Orla McNally
A1 Naven Chetty
A1 Kaijiang Liu
A1 Ken Jaaback
A1 Julio Lau
A1 Soon Yau Joseph Ng
A1 Henrik Falconer
A1 Jan Persson
A1 Russell Land
A1 Fabio Martinelli
A1 Andrea Garrett
A1 Alon Altman
A1 Adam Pendlebury
A1 David Cibula
A1 Roberto Altamirano
A1 Donal Brennan
A1 Thomas Edward Ind
A1 Cornelis De Kroon
A1 Ka Yu Tse
A1 George Hanna
A1 Andreas Obermair
YR 2021
UL http://ijgc.bmj.com/content/early/2021/03/31/ijgc-2020-002315.abstract
AB Introduction Sentinel lymph node dissection is widely used in the staging of endometrial cancer. Variation in surgical techniques potentially impacts diagnostic accuracy and oncologic outcomes, and poses barriers to the comparison of outcomes across institutions or clinical trial sites. Standardization of surgical technique and surgical quality assessment tools are critical to the conduct of clinical trials. By identifying mandatory and prohibited steps of sentinel lymph node (SLN) dissection in endometrial cancer, the purpose of this study was to develop and validate a competency assessment tool for use in surgical quality assurance.Methods A Delphi methodology was applied, included 35 expert gynecological oncology surgeons from 16 countries. Interviews identified key steps and tasks which were rated mandatory, optional, or prohibited using questionnaires. Using the surgical steps for which consensus was achieved, a competency assessment tool was developed and subjected to assessments of validity and reliability.Results Seventy percent consensus agreement standardized the specific mandatory, optional, and prohibited steps of SLN dissection for endometrial cancer and informed the development of a competency assessment tool. Consensus agreement identified 21 mandatory and three prohibited steps to complete a SLN dissection. The competency assessment tool was used to rate surgical quality in three preselected videos, demonstrating clear separation in the rating of the skill level displayed with mean skills summary scores differing significantly between the three videos (F score=89.4; P<0.001). Internal consistency of the items was high (Cronbach α=0.88).Conclusion Specific mandatory and prohibited steps of SLN dissection in endometrial cancer have been identified and validated based on consensus among a large number of international experts. A competency assessment tool is now available and can be used for surgeon selection in clinical trials and for ongoing, prospective quality assurance in routine clinical care.Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.