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Allan Okrainec - One of the best experts on this subject based on the ideXlab platform.
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feasibility of Remote Administration of the fundamentals of laparoscopic surgery fls skills test using google wearable device
Surgical Endoscopy and Other Interventional Techniques, 2020Co-Authors: Anton Nikouline, Carolina M Jimenez, Allan OkrainecAbstract:BACKGROUND: The fundamentals of laparoscopic surgery (FLS) program is a simulation-based training program designed to teach and assess the basic skills necessary for laparoscopic surgery. Preliminary work has demonstrated the feasibility of using Skype™ as a telesimulation modality in reliably scoring the exam for Remote centers. Google Glass (GG) (Mountain View, California) is referred to as a wearable computer containing a heads-up display and front-facing camera allowing point-of-view video transmission. The objective of this study was to evaluate the feasibility of GG in scoring the technical skills component of the FLS exam. METHODS: Twenty-eight participants were asked to complete the peg transfer and intracorporeal knot tasks of FLS using both GG and Skype™ setups. GG employed a third-party HIPAA-compliant video software (Pristine; Austin, TX) for video transmission. Participants were alternated between setups and evaluated by onsite and Remote proctors. Times and errors were recorded by both proctors. Interrater reliability of their FLS scores was compared using Intraclass Correlation Coefficients (ICCs). GG experience was evaluated based on participant survey responses using a 5-point Likert scale. RESULTS: Interrater reliability for GG demonstrated a statistically significant correlation between onsite (OP) and Remote (RP) proctors with ICCs of 0.985 (95% Confidence Interval [CI], 0.969-0.993) and 0.997 (95% CI 0.993-0.998), respectively, for peg and suture tasks. Skype™ demonstrated ICCs of 1.0 (95% CI 1.0-1.0). Average Likert scale responses found GG to be distracting (2.71), obstructive of the view (2.79), and a limitation to task execution (2.75). Overall, there was no statistical difference in scores between GG and Skype™ setups for either the peg (t = 1.446, p = 0.154) or suture task (t = - 0.710, p = 0.480), only 1 participant found the use of GG superior to Skype™. CONCLUSIONS: Our findings suggest that although GG are feasible in Remote assessment of FLS with strong interrater reliability (ICC > 0.95), Skype™ was the preferred modality.
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Feasibility of Remote Administration of the fundamentals of laparoscopic surgery (FLS) skills test using Google wearable device
Surgical Endoscopy, 2019Co-Authors: Anton Nikouline, M. Carolina Jimenez, Allan OkrainecAbstract:BackgroundThe fundamentals of laparoscopic surgery (FLS) program is a simulation-based training program designed to teach and assess the basic skills necessary for laparoscopic surgery. Preliminary work has demonstrated the feasibility of using Skype™ as a telesimulation modality in reliably scoring the exam for Remote centers. Google Glass (GG) (Mountain View, California) is referred to as a wearable computer containing a heads-up display and front-facing camera allowing point-of-view video transmission. The objective of this study was to evaluate the feasibility of GG in scoring the technical skills component of the FLS exam.MethodsTwenty-eight participants were asked to complete the peg transfer and intracorporeal knot tasks of FLS using both GG and Skype™ setups. GG employed a third-party HIPAA-compliant video software (Pristine; Austin, TX) for video transmission. Participants were alternated between setups and evaluated by onsite and Remote proctors. Times and errors were recorded by both proctors. Interrater reliability of their FLS scores was compared using Intraclass Correlation Coefficients (ICCs). GG experience was evaluated based on participant survey responses using a 5-point Likert scale.ResultsInterrater reliability for GG demonstrated a statistically significant correlation between onsite (OP) and Remote (RP) proctors with ICCs of 0.985 (95% Confidence Interval [CI], 0.969–0.993) and 0.997 (95% CI 0.993–0.998), respectively, for peg and suture tasks. Skype™ demonstrated ICCs of 1.0 (95% CI 1.0–1.0). Average Likert scale responses found GG to be distracting (2.71), obstructive of the view (2.79), and a limitation to task execution (2.75). Overall, there was no statistical difference in scores between GG and Skype™ setups for either the peg (t = 1.446, p = 0.154) or suture task (t = − 0.710, p = 0.480), only 1 participant found the use of GG superior to Skype™.ConclusionsOur findings suggest that although GG are feasible in Remote assessment of FLS with strong interrater reliability (ICC > 0.95), Skype™ was the preferred modality.
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Feasibility of Remote Administration of the Fundamentals of Laparoscopic Surgery (FLS) skills test
Surgical Endoscopy, 2013Co-Authors: Allan Okrainec, Melina Vassiliou, Andrew Kapoor, Kristen Pitzul, Oscar Henao, Pepa Kaneva, Timothy Jackson, E. Matt RitterAbstract:Background Fundamentals of Laparoscopic Surgery (FLS) certification testing currently is offered at accredited test centers or at select surgical conferences. Maintaining these test centers requires considerable investment in human and financial resources. Additionally, it can be challenging for individuals outside North America to become FLS certified. The objective of this pilot study was to assess the feasibility of Remotely administering and scoring the FLS examination using live videoconferencing compared with standard onsite testing. Methods This parallel mixed-methods study used both FLS scoring data and participant feedback to determine the barriers to feasibility of Remote proctoring for the FLS examination. Participants were tested at two accredited FLS testing centers. An official FLS proctor administered and scored the FLS exam Remotely while another onsite proctor provided a live score of participants’ performance. Participant feedback was collected during testing. Interrater reliabilities of onsite and Remote FLS scoring data were compared using intraclass correlation coefficients (ICCs). Participant feedback was analyzed using modified grounded theory to identify themes for barriers to feasibility. Results The scores of the Remote and onsite proctors showed excellent interrater reliability in the total FLS (ICC 0.995, CI [0.985–0.998]). Several barriers led to critical errors in Remote scoring, but most were accompanied by a solution incorporated into the study protocol. The most common barrier was the chain of custody for exam accessories. Conclusion The results of this pilot study suggest that Remote Administration of the FLS has the potential to decrease costs without altering test-taker scores or exam validity. Further research is required to validate protocols for Remote and onsite proctors and to direct execution of these protocols in a controlled environment identical to current FLS test Administration.
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feasibility of Remote Administration of the fundamentals of laparoscopic surgery fls skills test
Surgical Endoscopy and Other Interventional Techniques, 2013Co-Authors: Allan Okrainec, Melina Vassiliou, Andrew Kapoor, Kristen Pitzul, Oscar Henao, Pepa Kaneva, Timothy D Jackson, Matt E RitterAbstract:Background Fundamentals of Laparoscopic Surgery (FLS) certification testing currently is offered at accredited test centers or at select surgical conferences. Maintaining these test centers requires considerable investment in human and financial resources. Additionally, it can be challenging for individuals outside North America to become FLS certified. The objective of this pilot study was to assess the feasibility of Remotely administering and scoring the FLS examination using live videoconferencing compared with standard onsite testing.
Lee H Schwamm - One of the best experts on this subject based on the ideXlab platform.
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role for telemedicine in acute stroke feasibility and reliability of Remote Administration of the nih stroke scale
Stroke, 1999Co-Authors: Saad Shafqat, Joseph C Kvedar, Mary Guanci, Yuchiao Chang, Lee H SchwammAbstract:Background and Purpose —Immediate access to physicians experienced in acute stroke treatment may improve clinical outcomes in patients with acute stroke. Interactive telemedicine can make stroke specialists available to assist in the evaluation of patients at multiple urban or Remote rural facilities. We tested whether interrater agreement for the NIH Stroke Scale (NIHSS), a critical component of acute stroke assessment, would persist if performed over a telemedicine link. Methods —One bedside and 1 Remote NIHSS score were independently obtained on each of 20 patients with ischemic stroke. The bedside examination was performed by a stroke neurologist at the patient’s bedside. The Remote examination was performed by a second stroke neurologist through an interactive high-speed audio-video link, assisted by a nurse at the patient’s bedside. Kappa coefficients were calculated for concordance between bedside and Remote scores. Results —Remote assessments took slightly longer than bedside assessments (mean 9.70 versus 6.55 minutes, P <0.001). NIHSS scores ranged from 1 through 24. Based on weighted κ coefficients, 4 items (orientation, motor arm, motor leg, and neglect) displayed excellent agreement, 6 items (language, dysarthria, sensation, visual fields, facial palsy, and gaze) displayed good agreement, and 2 items (commands and ataxia) displayed poor agreement. Total NIHSS scores obtained by bedside and Remote methods were strongly correlated ( r =0.97, P <0.001). Conclusions —The NIH Stroke Scale remains a swift and reliable clinical instrument when used over interactive video. Application of this technology can bring stroke expertise to the bedside, regardless of patient location.
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Role for telemedicine in acute stroke feasibility and reliability of Remote Administration of the NIH stroke scale
Stroke, 1999Co-Authors: Saad Shafqat, Joseph C Kvedar, Mary Guanci, Yuchiao Chang, Lee H SchwammAbstract:Background and Purpose —Immediate access to physicians experienced in acute stroke treatment may improve clinical outcomes in patients with acute stroke. Interactive telemedicine can make stroke specialists available to assist in the evaluation of patients at multiple urban or Remote rural facilities. We tested whether interrater agreement for the NIH Stroke Scale (NIHSS), a critical component of acute stroke assessment, would persist if performed over a telemedicine link. Methods —One bedside and 1 Remote NIHSS score were independently obtained on each of 20 patients with ischemic stroke. The bedside examination was performed by a stroke neurologist at the patient’s bedside. The Remote examination was performed by a second stroke neurologist through an interactive high-speed audio-video link, assisted by a nurse at the patient’s bedside. Kappa coefficients were calculated for concordance between bedside and Remote scores. Results —Remote assessments took slightly longer than bedside assessments (mean 9.70 versus 6.55 minutes, P
Anton Nikouline - One of the best experts on this subject based on the ideXlab platform.
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feasibility of Remote Administration of the fundamentals of laparoscopic surgery fls skills test using google wearable device
Surgical Endoscopy and Other Interventional Techniques, 2020Co-Authors: Anton Nikouline, Carolina M Jimenez, Allan OkrainecAbstract:BACKGROUND: The fundamentals of laparoscopic surgery (FLS) program is a simulation-based training program designed to teach and assess the basic skills necessary for laparoscopic surgery. Preliminary work has demonstrated the feasibility of using Skype™ as a telesimulation modality in reliably scoring the exam for Remote centers. Google Glass (GG) (Mountain View, California) is referred to as a wearable computer containing a heads-up display and front-facing camera allowing point-of-view video transmission. The objective of this study was to evaluate the feasibility of GG in scoring the technical skills component of the FLS exam. METHODS: Twenty-eight participants were asked to complete the peg transfer and intracorporeal knot tasks of FLS using both GG and Skype™ setups. GG employed a third-party HIPAA-compliant video software (Pristine; Austin, TX) for video transmission. Participants were alternated between setups and evaluated by onsite and Remote proctors. Times and errors were recorded by both proctors. Interrater reliability of their FLS scores was compared using Intraclass Correlation Coefficients (ICCs). GG experience was evaluated based on participant survey responses using a 5-point Likert scale. RESULTS: Interrater reliability for GG demonstrated a statistically significant correlation between onsite (OP) and Remote (RP) proctors with ICCs of 0.985 (95% Confidence Interval [CI], 0.969-0.993) and 0.997 (95% CI 0.993-0.998), respectively, for peg and suture tasks. Skype™ demonstrated ICCs of 1.0 (95% CI 1.0-1.0). Average Likert scale responses found GG to be distracting (2.71), obstructive of the view (2.79), and a limitation to task execution (2.75). Overall, there was no statistical difference in scores between GG and Skype™ setups for either the peg (t = 1.446, p = 0.154) or suture task (t = - 0.710, p = 0.480), only 1 participant found the use of GG superior to Skype™. CONCLUSIONS: Our findings suggest that although GG are feasible in Remote assessment of FLS with strong interrater reliability (ICC > 0.95), Skype™ was the preferred modality.
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Feasibility of Remote Administration of the fundamentals of laparoscopic surgery (FLS) skills test using Google wearable device
Surgical Endoscopy, 2019Co-Authors: Anton Nikouline, M. Carolina Jimenez, Allan OkrainecAbstract:BackgroundThe fundamentals of laparoscopic surgery (FLS) program is a simulation-based training program designed to teach and assess the basic skills necessary for laparoscopic surgery. Preliminary work has demonstrated the feasibility of using Skype™ as a telesimulation modality in reliably scoring the exam for Remote centers. Google Glass (GG) (Mountain View, California) is referred to as a wearable computer containing a heads-up display and front-facing camera allowing point-of-view video transmission. The objective of this study was to evaluate the feasibility of GG in scoring the technical skills component of the FLS exam.MethodsTwenty-eight participants were asked to complete the peg transfer and intracorporeal knot tasks of FLS using both GG and Skype™ setups. GG employed a third-party HIPAA-compliant video software (Pristine; Austin, TX) for video transmission. Participants were alternated between setups and evaluated by onsite and Remote proctors. Times and errors were recorded by both proctors. Interrater reliability of their FLS scores was compared using Intraclass Correlation Coefficients (ICCs). GG experience was evaluated based on participant survey responses using a 5-point Likert scale.ResultsInterrater reliability for GG demonstrated a statistically significant correlation between onsite (OP) and Remote (RP) proctors with ICCs of 0.985 (95% Confidence Interval [CI], 0.969–0.993) and 0.997 (95% CI 0.993–0.998), respectively, for peg and suture tasks. Skype™ demonstrated ICCs of 1.0 (95% CI 1.0–1.0). Average Likert scale responses found GG to be distracting (2.71), obstructive of the view (2.79), and a limitation to task execution (2.75). Overall, there was no statistical difference in scores between GG and Skype™ setups for either the peg (t = 1.446, p = 0.154) or suture task (t = − 0.710, p = 0.480), only 1 participant found the use of GG superior to Skype™.ConclusionsOur findings suggest that although GG are feasible in Remote assessment of FLS with strong interrater reliability (ICC > 0.95), Skype™ was the preferred modality.
Ian R Sharp - One of the best experts on this subject based on the ideXlab platform.
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face to face versus Remote Administration of the montgomery asberg depression rating scale using videoconference and telephone
Depression and Anxiety, 2008Co-Authors: Kenneth A Kobak, Janet B W Williams, Elizabeth L Jeglic, Donna Salvucci, Ian R SharpAbstract:Although the use of telemedicine in psychiatry has a long history in providing clinical care to patients, its use in clinical trials research has not yet been commonly employed. Telemedicine allows for the Remote assessment of study patients, which could be done by a centralized, highly calibrated, and impartial cohort of raters independent of the study site. This study examined the comparability of Remote Administration of the Montgomery–Asberg Depression Rating Scale (MADRS) by videoconference and by telephone to traditional face-to-face Administration. Two parallel studies were conducted: one compared face-to-face with videoconference Administration (N=35), and the other compared face-to-face with telephone Administration (N=35). In each study, depressed patients were interviewed independently twice: once in the traditional face-to-face manner, and the second time by either videoconference or teleconference. A counterbalanced order was used. The mean MADRS score for interviews conducted Remotely by videoconference was not significantly different from the mean MADRS scores conducted by face-to-face Administration (mean difference=0.51 points), P=.388, intraclass correlation (ICC)=.94, P<0001. Similarly, the mean MADRS score for interviews conducted by telephone was not significantly different from the mean MADRS score conducted by face-to-face Administration (mean difference=0.74 points), P=.270, ICC=.93, P<0001. Results of the study support the comparability of Remote Administration of the MADRS, by both telephone and videoconference, to face-to-face Administration. Comparability of the Administration mode allows for Remote assessment of patients in both research and clinical applications. Depression and Anxiety, 2008. © 2007 Wiley-Liss, Inc.
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Face-to-face versus Remote Administration of the Montgomery-Asberg Depression Rating Scale using videoconference and telephone.
Depression and Anxiety, 2008Co-Authors: Kenneth A Kobak, Janet B W Williams, Elizabeth L Jeglic, Donna Salvucci, Ian R SharpAbstract:Although the use of telemedicine in psychiatry has a long history in providing clinical care to patients, its use in clinical trials research has not yet been commonly employed. Telemedicine allows for the Remote assessment of study patients, which could be done by a centralized, highly calibrated, and impartial cohort of raters independent of the study site. This study examined the comparability of Remote Administration of the Montgomery–Asberg Depression Rating Scale (MADRS) by videoconference and by telephone to traditional face-to-face Administration. Two parallel studies were conducted: one compared face-to-face with videoconference Administration (N=35), and the other compared face-to-face with telephone Administration (N=35). In each study, depressed patients were interviewed independently twice: once in the traditional face-to-face manner, and the second time by either videoconference or teleconference. A counterbalanced order was used. The mean MADRS score for interviews conducted Remotely by videoconference was not significantly different from the mean MADRS scores conducted by face-to-face Administration (mean difference=0.51 points), P=.388, intraclass correlation (ICC)=.94, P
Saad Shafqat - One of the best experts on this subject based on the ideXlab platform.
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role for telemedicine in acute stroke feasibility and reliability of Remote Administration of the nih stroke scale
Stroke, 1999Co-Authors: Saad Shafqat, Joseph C Kvedar, Mary Guanci, Yuchiao Chang, Lee H SchwammAbstract:Background and Purpose —Immediate access to physicians experienced in acute stroke treatment may improve clinical outcomes in patients with acute stroke. Interactive telemedicine can make stroke specialists available to assist in the evaluation of patients at multiple urban or Remote rural facilities. We tested whether interrater agreement for the NIH Stroke Scale (NIHSS), a critical component of acute stroke assessment, would persist if performed over a telemedicine link. Methods —One bedside and 1 Remote NIHSS score were independently obtained on each of 20 patients with ischemic stroke. The bedside examination was performed by a stroke neurologist at the patient’s bedside. The Remote examination was performed by a second stroke neurologist through an interactive high-speed audio-video link, assisted by a nurse at the patient’s bedside. Kappa coefficients were calculated for concordance between bedside and Remote scores. Results —Remote assessments took slightly longer than bedside assessments (mean 9.70 versus 6.55 minutes, P <0.001). NIHSS scores ranged from 1 through 24. Based on weighted κ coefficients, 4 items (orientation, motor arm, motor leg, and neglect) displayed excellent agreement, 6 items (language, dysarthria, sensation, visual fields, facial palsy, and gaze) displayed good agreement, and 2 items (commands and ataxia) displayed poor agreement. Total NIHSS scores obtained by bedside and Remote methods were strongly correlated ( r =0.97, P <0.001). Conclusions —The NIH Stroke Scale remains a swift and reliable clinical instrument when used over interactive video. Application of this technology can bring stroke expertise to the bedside, regardless of patient location.
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Role for telemedicine in acute stroke feasibility and reliability of Remote Administration of the NIH stroke scale
Stroke, 1999Co-Authors: Saad Shafqat, Joseph C Kvedar, Mary Guanci, Yuchiao Chang, Lee H SchwammAbstract:Background and Purpose —Immediate access to physicians experienced in acute stroke treatment may improve clinical outcomes in patients with acute stroke. Interactive telemedicine can make stroke specialists available to assist in the evaluation of patients at multiple urban or Remote rural facilities. We tested whether interrater agreement for the NIH Stroke Scale (NIHSS), a critical component of acute stroke assessment, would persist if performed over a telemedicine link. Methods —One bedside and 1 Remote NIHSS score were independently obtained on each of 20 patients with ischemic stroke. The bedside examination was performed by a stroke neurologist at the patient’s bedside. The Remote examination was performed by a second stroke neurologist through an interactive high-speed audio-video link, assisted by a nurse at the patient’s bedside. Kappa coefficients were calculated for concordance between bedside and Remote scores. Results —Remote assessments took slightly longer than bedside assessments (mean 9.70 versus 6.55 minutes, P