Consistency of video-based operation ability rating scale for manual small incision cataract surgery

Abstract

Objective To evaluate the feasibility and consistency of surgical recordings by small incision cataract surgery (MSICS) operation ability rating scale,Ophthalmology Surgical Competency Assessment Rubric (OSCAR),which was proposed by International Council of Ophthalmology.Methods Ten MSICS procedures performed by ten trainees who had undergone our manual small incision cataract surgery training program were recorded with a external digital-video-recorder by professional technician in 10 county-level hospitals,then these videos were graded by 2 different professional trainers using a 5-point scale,ranging from 2 (not very skilled) to 5 (skilled),according to the ICO-SICS.The score was 0 if the particular step was finished by the trainer.After two weeks,these recordings were graded once more by the same method.Kappa value was used to assess the inter-rater consistency and intra-rater retest reliability.Results Available data and videos were collected from 10 surgeons,aged from 29 to 48 with a median age of 40.The mean kappa value of inter-observer reproducibility for each surgical step was 0.866 (0.734 ～ 0.982).The retest reliabilities of both trainers were over 0.800,with a mean kappa value of 0.921 (range:0.843 ～ 0.981) for trainer A and 0.926 (range:0.854 ～ 0.978)for trainer B.Conclusions According to ICO-OSCR:SICS scale,external video system is an effective and consistent assessment of the quality of each step of SICS.This method can be a method for trainees'surgery quality remote monitoring and self-assessment. Key words: Small incision cataract surgery; Video; Ophthalmology surgical competency assessment rubric; consistency