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madeleine selvander, Peter Åsman; A Comparison Between Eyesi Internal Scoring And Human-based Video Scoring In Virtual Reality Cataract Surgery Simulation. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6722.
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To compare the internal computer-based scoring (IS) with human-based video scoring (VS) of cataract modules in the Eyesi virtual reality intraocular surgical simulator.
Seven cataract surgeons and seventeen medical students participated in the study which included training in three cataract modules (capsulorhexis, hydromaneuvers and phaco divide and conquer). For each module, an instructional movie, and a familiarization iteration immediately preceded the session used in this study which included one trial with each of the capsulorhexis, hydromaneuvers, and phaco divide and conquer modules in that order.For each module, the simulator calculates an overall score for the performance ranging from 0 to 100 (IS). The training was also video recorded. Two experienced cataract surgeons (assessors), masked regaring the subjects’ identity, subsequently analyzed the videos using the Objective Assessment of Cataract Surgical Skill (OSACSS). For each module, the average of the two assessors’ OSACSS scores was used as video based performance score (VS). The OSACSS has previously been validated as a scoring tool for real cataract operations.The ability to discriminate surgeons from naïve individuals using the internal score (IS) and the human video-scoring (VS) respectively was investigated and compared using ROC-curves.
The video-based scoring (VS) was superior compared to the internal scoring of the simulator (IS) for the phaco divide and conquer procedure, ROC area 0.945 vs 0.664 (p=0.046). The ROC areas for capsulorhexis were 0.887 (VS) and 0.761 (IS) and for hydromaneuvers 0.817 (VS) and 0.571 (IS), the differences were non-significant p=0.34 and p=0.1 respectively.
The internal performance (IS) ROC areas were disappointingly low. Video-based scoring of the phaco procedure was superior to the innate simulator scoring system in distinguishing cataract surgical skills. Our results indicate an improvement potential in the internal computer-based scoring of the phaco divide and conquer module and possibly also for the other two modules capsulorhexis and hydromaneuvers.
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