Consistency in endovascular aneurysm repair suitability assessment requires group decision audit

Journal of Vascular Surgery
Steffan G J RödelFrans L Moll

Abstract

Proper selection of patient and stent-graft combinations in endovascular aneurysm repair (EVAR) depends on knowledge and experience with the different types of stents that have to be adapted to the patient's unique abdominal aortoiliac anatomy. The aim of this study was to analyze the consistency and variance in EVAR suitability assessment between clinicians. Worksheets that contained anatomic data derived from computed tomography scans and angiography were compiled for 202 patients. Five clinicians, all experienced in EVAR surgery, assessed the anatomic data on the worksheets for suitability for three types of stent-grafts. The obtained 3030 assessments represented a quantification of the likelihood of success the clinician expected for effective and durable sealing and fixation of the stent-graft in EVAR. The Delphi method was used to determine consensus in the thinking process among clinicians, and kappa analysis was used to determine the proportion of variances in the assessment result between clinicians. With the Delphi method, Cronbach alpha values of 0.87, 0.87, and 0.90 were reached for the three types of stent-grafts in the second assessment round. The individual clinician-group correlation in round two was between 0.6...Continue Reading

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Citations

Nov 1, 2011·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Natalia MajewskaWaclaw Majewski
Dec 31, 2011·The Annals of Thoracic Surgery·Natalia MajewskaWacław Majewski
Nov 2, 2007·Advances in Surgery·Matthew J BownPeter R F Bell
Nov 9, 2007·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·L L HoornwegR Balm
Jul 26, 2011·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·K R EideO Haraldseth
Jul 14, 2010·Journal of Vascular Surgery·Teviah SachsMarc Schermerhorn
Jul 14, 2012·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Tamer GhatwaryPeter J Holt

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