Learning curve evaluation using cumulative summation analysis-a clinical example of pediatric robot-assisted laparoscopic pyeloplasty

Journal of Pediatric Surgery
Thomas P CundyAzad S Najmaldin

Abstract

The cumulative summation (CUSUM) method for learning curve analysis remains under-utilized in the surgical literature in general, and is described in only a small number of publications within the field of pediatric surgery. This study introduces the CUSUM analysis technique and applies it to evaluate the learning curve for pediatric robot-assisted laparoscopic pyeloplasty (RP). Clinical data were prospectively recorded for consecutive pediatric RP cases performed by a single-surgeon. CUSUM charts and tests were generated for set-up time, docking time, console time, operating time, total operating room time, and postoperative complications. Conversions and avoidable operating room delay were separately evaluated with respect to case experience. Comparisons between case experience and time-based outcomes were assessed using the Student's t-test and ANOVA for bi-phasic and multi-phasic learning curves respectively. Comparison between case experience and complication frequency was assessed using the Kruskal-Wallis test. A total of 90 RP cases were evaluated. The learning curve transitioned beyond the learning phase at cases 10, 15, 42, 57, and 58 for set-up time, docking time, console time, operating time, and total operating room...Continue Reading

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Citations

Apr 12, 2017·Scandinavian Journal of Urology·Susanne ReinhardtJorgen Thorup
Jul 14, 2018·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Aodhnait S FahyGeorges Azzie
Jul 18, 2019·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Atsuhisa FukutaTomoaki Taguchi
Mar 7, 2019·Investigative and Clinical Urology·Bum Sik TaeJae Young Park
Apr 18, 2019·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Su Yeon AhnJin Mo Goo
Feb 23, 2020·Journal of Robotic Surgery·Emma M van der SchansIvo A M J Broeders
Mar 3, 2021·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Grazia SpampinatoQuentin Ballouhey
Jun 30, 2021·Academic Medicine : Journal of the Association of American Medical Colleges·Claudio ViolatoOzge Ersan
Nov 23, 2021·Journal of Endourology·David Theodore GreenwaldMohan Gundeti

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