Tobias Todsen1,2, Jacob Melchiors1,2, Birgitte Charabi1, Birthe Henriksen3, Charlotte Ringsted4, Lars Konge2, Christian von Buchwald1. 1. Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, University of Copenhagen and the Capital Region of Denmark, Copenhagen. 2. Copenhagen Academy for Medical Education and Simulation, University of Copenhagen and the Capital Region of Denmark, Copenhagen. 3. Department of Radiology, Ultrasound Section, Diagnostic Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen. 4. Centre for Health Science Education, Faculty of Health, Aarhus University, Aarhus, Denmark.
Abstract
OBJECTIVE: Head and neck ultrasonography (HNUS) increasingly is used as a point-of-care diagnostic tool by otolaryngologists. However, ultrasonography (US) is a very operator-dependent image modality. Hence, this study aimed to explore the diagnostic accuracy of surgeon-performed HNUS and to establish validity evidence for an objective structured assessment of ultrasound skills (OSAUS) used for competency-based assessment. STUDY DESIGN: A prospective experimental study. METHODS: Six otolaryngologists and 11 US novices were included in a standardized test setup for which they had to perform focused HNUS of eight patients suspected for different head and neck lesions. Their diagnostic accuracy was calculated based on the US reports, and two blinded raters assessed the video-recorded US performance using the OSAUS scale. RESULTS: The otolaryngologists obtained a high diagnostic accuracy on 88% (range 63%-100%) compared to the US novices on 38% (range 0-63%); P < 0.001. The OSAUS score demonstrated good inter-case reliability (0.85) and inter-rater reliability (0.76), and significant discrimination between otolaryngologist and US novices; P < 0.001. A strong correlation between the OSAUS score and the diagnostic accuracy was found (Spearman's ρ, 0.85; P < P 0.001), and a pass/fail score was established at 2.8. CONCLUSION: Strong validity evidence supported the use of the OSAUS scale to assess HNUS competence with good reliability, significant discrimination between US competence levels, and a strong correlation of assessment score to diagnostic accuracy. An OSAUS pass/fail score was established and could be used for competence-based assessment in surgeon-performed HNUS. LEVEL OF EVIDENCE: NA. Laryngoscope, 128:1346-1352, 2018.
OBJECTIVE: Head and neck ultrasonography (HNUS) increasingly is used as a point-of-care diagnostic tool by otolaryngologists. However, ultrasonography (US) is a very operator-dependent image modality. Hence, this study aimed to explore the diagnostic accuracy of surgeon-performed HNUS and to establish validity evidence for an objective structured assessment of ultrasound skills (OSAUS) used for competency-based assessment. STUDY DESIGN: A prospective experimental study. METHODS: Six otolaryngologists and 11 US novices were included in a standardized test setup for which they had to perform focused HNUS of eight patients suspected for different head and neck lesions. Their diagnostic accuracy was calculated based on the US reports, and two blinded raters assessed the video-recorded US performance using the OSAUS scale. RESULTS: The otolaryngologists obtained a high diagnostic accuracy on 88% (range 63%-100%) compared to the US novices on 38% (range 0-63%); P < 0.001. The OSAUS score demonstrated good inter-case reliability (0.85) and inter-rater reliability (0.76), and significant discrimination between otolaryngologist and US novices; P < 0.001. A strong correlation between the OSAUS score and the diagnostic accuracy was found (Spearman's ρ, 0.85; P < P 0.001), and a pass/fail score was established at 2.8. CONCLUSION: Strong validity evidence supported the use of the OSAUS scale to assess HNUS competence with good reliability, significant discrimination between US competence levels, and a strong correlation of assessment score to diagnostic accuracy. An OSAUS pass/fail score was established and could be used for competence-based assessment in surgeon-performed HNUS. LEVEL OF EVIDENCE: NA. Laryngoscope, 128:1346-1352, 2018.
Authors: Thomas Løkkegaard; Tobias Todsen; Leizl Joy Nayahangan; Camilla Aakjaer Andersen; Martin Bach Jensen; Lars Konge Journal: Scand J Prim Health Care Date: 2020-01-20 Impact factor: 2.581