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The impact of surgical simulation on patient outcomes: a systematic review and meta-analysis.
Neurosurgical Review ( IF 2.8 ) Pub Date : 2020-05-13 , DOI: 10.1007/s10143-020-01314-2 Trym R Meling 1 , Torstein R Meling 1, 2, 3
Neurosurgical Review ( IF 2.8 ) Pub Date : 2020-05-13 , DOI: 10.1007/s10143-020-01314-2 Trym R Meling 1 , Torstein R Meling 1, 2, 3
Affiliation
The use of simulation in surgical training is ever growing. Evidence suggests such training may have beneficial clinically relevant effects. The objective of this research is to investigate the effects of surgical simulation training on clinically relevant patient outcomes by evaluating randomized controlled trials (RCT). PubMed was searched using PRISMA guidelines: "surgery" [All Fields] AND "simulation" [All Fields] AND "patient outcome" [All Fields]. Of 119 papers identified, 100 were excluded for various reasons. Meta-analyses were conducted using the inverse-variance random-effects method. Nineteen papers were reviewed using the CASP RCT Checklist. Sixteen studies looked at surgical training, two studies assessed patient-specific simulator practice, and one paper focused on warming-up on a simulator before performing surgery. Median study population size was 22 (range 3-73). Most articles reported outcome measures such as post-intervention Global Rating Scale (GRS) score and/or operative time. On average, the intervention group scored 0.42 (95% confidence interval 0.12 to 0.71, P = 0.005) points higher on a standardized GRS scale of 1-10. On average, the intervention group was 44% (1% to 87%, P = 0.04) faster than the control group. Four papers assessed the impact of simulation training on patient outcomes, with only one finding a significant effect. We found a significant effect of simulation training on operative performance as assessed by GRS, albeit a small one, as well as a significant reduction to operative time. However, there is to date scant evidence from RCTs to suggest a significant effect of surgical simulation training on patient outcomes.
中文翻译:
手术模拟对患者结果的影响:系统评价和荟萃分析。
模拟在外科训练中的应用越来越多。有证据表明,此类培训可能具有有益的临床相关效果。本研究的目的是通过评估随机对照试验 (RCT) 来研究手术模拟训练对临床相关患者结果的影响。使用 PRISMA 指南搜索 PubMed:“手术”[所有字段] 和“模拟”[所有字段] 和“患者结果”[所有字段]。在确定的 119 篇论文中,有 100 篇因各种原因被排除在外。使用逆方差随机效应方法进行荟萃分析。使用 CASP RCT 检查表审查了 19 篇论文。16 项研究着眼于手术训练,两项研究评估了患者特定的模拟器实践,和一篇论文专注于在进行手术前在模拟器上热身。中位数研究人口规模为 22(范围 3-73)。大多数文章报告了干预后全球评定量表 (GRS) 评分和/或手术时间等结局指标。平均而言,干预组在标准化的 GRS 量表 1-10 中得分高 0.42(95% 置信区间 0.12 至 0.71,P = 0.005)。平均而言,干预组比对照组快 44%(1% 到 87%,P = 0.04)。四篇论文评估了模拟训练对患者结果的影响,只有一篇论文发现了显着影响。我们发现模拟训练对 GRS 评估的手术表现有显着影响,尽管影响很小,并且显着减少了手术时间。然而,
更新日期:2020-05-13
中文翻译:
手术模拟对患者结果的影响:系统评价和荟萃分析。
模拟在外科训练中的应用越来越多。有证据表明,此类培训可能具有有益的临床相关效果。本研究的目的是通过评估随机对照试验 (RCT) 来研究手术模拟训练对临床相关患者结果的影响。使用 PRISMA 指南搜索 PubMed:“手术”[所有字段] 和“模拟”[所有字段] 和“患者结果”[所有字段]。在确定的 119 篇论文中,有 100 篇因各种原因被排除在外。使用逆方差随机效应方法进行荟萃分析。使用 CASP RCT 检查表审查了 19 篇论文。16 项研究着眼于手术训练,两项研究评估了患者特定的模拟器实践,和一篇论文专注于在进行手术前在模拟器上热身。中位数研究人口规模为 22(范围 3-73)。大多数文章报告了干预后全球评定量表 (GRS) 评分和/或手术时间等结局指标。平均而言,干预组在标准化的 GRS 量表 1-10 中得分高 0.42(95% 置信区间 0.12 至 0.71,P = 0.005)。平均而言,干预组比对照组快 44%(1% 到 87%,P = 0.04)。四篇论文评估了模拟训练对患者结果的影响,只有一篇论文发现了显着影响。我们发现模拟训练对 GRS 评估的手术表现有显着影响,尽管影响很小,并且显着减少了手术时间。然而,