المؤلفون: Feifer, Andrew^1,2, Al-Ammari, Adel¹, Kovac, Evan¹, Delisle, Josee¹, Carrier, Serge^1,2, Anidjar, Maurice^1,3

المصدر: BJU International. Nov2011, Vol. 108 Issue 10, p1652-1656. 5p. 3 Color Photographs, 1 Chart.

مصطلحات موضوعية: *ROBOTICS, *LAPAROSCOPY, *VIRTUAL reality therapy, *CLINICAL competence, *HEALTH outcome assessment

مستخلص: Study Type - Therapy (outcomes research) Level of Evidence 2c OBJECTIVE [ABSTRACT FROM AUTHOR]

المؤلفون: Feifer, Andrew, Delisle, Josee, Anidjar, Maurice

المصدر: Journal of Urology; Oct2008, Vol. 180 Issue 4, p1455-1459, 5p

مصطلحات موضوعية: LAPAROSCOPY, COMPUTER simulation, MEDICAL robotics, CLINICAL competence, MEDICAL care, UROLOGY, RESIDENTS (Medicine)

مستخلص: Purpose: We examined the usefulness, reliability and applicability of the smoothness metric of the ProMIS hybrid simulator (Haptica, Dublin, Ireland) for a urology residency program. Materials and Methods: A total of 15 urology residents divided into junior and senior cohorts were followed prospectively for 6 training sessions. Validated McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) laparoscopic tasks were used. The ProMIS hybrid simulator smoothness parameter, a unit-free metric of movement efficiency, was recorded using 3-dimensional visual tracking technology. Results were compared between cohorts at the midpoint and end of the defined training sessions. End of study junior means were also retrospectively compared to senior mid training means. Statistical significance was determined using the Mann-Whitney U test (α = 0.05). Results: Statistically significant differences between 8 junior and 7 senior cohorts were measured in all MISTELS tasks. A statistically significant performance variation was also detected at the mid and end testing times. When juniors and seniors were compared between sessions 1 and 3, and 4 and 6, statistically significant performance improvements were noted. Lastly, statistical differences were also maintained when mid session senior means were compared to end of session junior means. A 38% improvement in task completion in the senior cohort as well as a 10-fold decrease in variance was observed compared to a 12% improvement in juniors, indicating greater efficiency of movement in seniors. Conclusions: The laparoscopic smoothness metric in the hybrid simulator demonstrated construct validity by effectively differentiating between experienced and novice urology residents using validated MISTELS tasks. The outcome suggests that the hybrid simulator smoothness metric is a valuable asset in residency programs for preparatory training for live operative experience, allowing improved trainee assessment. [Copyright &y& Elsevier]

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المؤلفون: Mirkin, Joshua N.¹ joshua.mirkin@downstate.edu, Lowrance, William T.^2,3, Feifer, Andrew H.^4,5, Mulhall, John P.⁶, Eastham, James E.⁷, Elkin, Elena B.⁸

المصدر: Health Affairs. Apr2012, Vol. 31 Issue 4, p760-769. 10p.

مصطلحات موضوعية: *PROSTATECTOMY, *CONSUMER information services, *MEDICINE information services, *ADVERTISING, *CONTENT analysis, *DECISION making, *ENDOSCOPIC surgery, *INTERNET, *HEALTH outcome assessment, *PATIENTS, *PROSTATE tumors, *RISK assessment, *ROBOTICS, *WORLD Wide Web, *GOVERNMENT regulation, *TREATMENT effectiveness, *DESCRIPTIVE statistics, *EQUIPMENT & supplies, *STANDARDS

مستخلص: Robotic surgery to remove a cancerous prostate has become a popular treatment. Internet marketing of this surgery provides an intriguing case study of direct-to-consumer promotions of medical devices, which are more loosely regulated than pharmaceutical promotions. We investigated whether the claims made in online promotions of robotic prostatectomy were consistent with evidence from comparative effectiveness studies. After performing a search and cross-sectional analysis of websites that mentioned the procedure, we found that many sites claimed benefits that were unsupported by evidence and that 42 percent of the sites failed to mention risks. Most sites were published by hospitals and physicians, which the public may regard as more objective than pages published by manufacturers. Unbalanced information may inappropriately raise patients' expectations. Increasing enforcement and regulation of online promotions may be beyond the capabilities of federal authorities. Thus, the most feasible solution may be for the government and medical societies to promote the production of balanced educational material. [ABSTRACT FROM AUTHOR]