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Reliability and Validity of 2 Surgical Prioritization Systems for Reinstating Nonemergent Benign Gynecologic Surgery during the COVID-19 Pandemic. | LitMetric

Reliability and Validity of 2 Surgical Prioritization Systems for Reinstating Nonemergent Benign Gynecologic Surgery during the COVID-19 Pandemic.

J Minim Invasive Gynecol

Departments of Obstetrics and Gynecology (Drs. Marfori, Klebanoff, Wu, Barnes, Carter-Brooks); Surgery (Dr. Amdur), The George Washington University Hospital, Washington, District of Columbia.

Published: April 2021

AI Article Synopsis

  • This study aimed to assess the effectiveness and consistency of two new surgical triaging systems (Gyn-MeNTS and mESAS) for prioritizing gynecologic surgeries, particularly for patients affected by COVID-19 delays.
  • Conducted in an academic hospital, the research analyzed scores from 97 patients using specific scoring metrics that correlated urgency with surgery prioritization.
  • The results demonstrated strong reliability for Gyn-MeNTS scores among raters and moderate reliability for mESAS, indicating that both systems can effectively support surgical decision-making with significant agreement between different raters.

Article Abstract

Study Objective: Scientifically evaluate the validity and reproducibility of 2 novel surgical triaging systems, as well as offer modifications to the Medically-Necessary, Time-Sensitive (MeNTS) criteria for improved application in gynecologic surgeries.

Design: Retrospective cohort study.

Setting: Academic university hospital.

Patients: Ninety-seven patients with delayed benign gynecologic procedures owing to the coronavirus disease 2019 pandemic.

Intervention(s): Surgical prioritization was assessed using 2 novel scoring systems, the Gynecologic Medically-Necessary Time-Sensitive (Gyn-MeNTS) and modified Elective Surgery Acuity Scale (mESAS) systems for all 93 patients included.

Measurements And Main Results: The interrater reliability and validity of 2 novel surgical prioritization systems (Gyn-MeNTS and mESAS) were assessed. The Gyn-MeNTS scores were calculated by 3 raters and analyzed as continuous variables, with a lower score indicating more urgency/priority. The mESAS score was calculated by 2 raters and analyzed as a 3-level ordinal variable with a higher score indicating more urgency/priority. All 5 raters were blinded to reduce bias. The Gyn-MeNTS interrater reliability was tested using Spearman r and paired t tests were used to detect systematic differences between raters. Weighted κ indicated mESAS reliability. Concurrent validity with mESAS and surgeon self-prioritization (SSP) was examined with Spearman r and logistic regression. Spearman r's for all Gyn-MeNTS rater pairs were above 0.80 (0.84 for 1 vs 2; 0.82 for 1 vs 3; and 0.82 for 2 vs 3, all p <.001) indicating strong agreement. The weighted κ for the 2 mESAS raters was 0.57 (95% confidence interval, 0.40-0.73) indicating moderate agreement. When used together, both scores were significantly independently associated with SSP, with strong discrimination (area under the curve, 0.89).

Conclusion: Interrater reliability is acceptable for both scoring systems, and concurrent validity of each is moderate for predicting SSP, but discrimination improves to a high level when they are used together.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392134PMC
http://dx.doi.org/10.1016/j.jmig.2020.07.024DOI Listing

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