title: The technicity index: a useful performance indicator for minimally invasive surgery in the management of endometrial cancer.
abstract: BACKGROUND
  Minimally invasive surgery is the surgical approach of choice for the management of numerous non-oncologic and oncologic conditions. The Technicity Index (TI) is defined in this study as the ratio of minimally invasive hysterectomies to abdominal hysterectomies performed during the studied time period. The TI indicates, in this context, the level of surgical technique and can thus be used as a health care indicator. The objective of this study was to evaluate whether the TI of the surgical management of endometrial cancer had significantly increased over three different time periods in our gynaecologic oncology division.
  
  
  METHODS
  The TI was calculated from the data recorded in a surgical management system from July 1999 to June 2011. The study period was divided into three equal time periods (P1: July 1999 to June 2003; P2: July 2003 to June 2007; P3: July 2007 to June 2011). The z-score was used to compare the TI in each period, with P = 0.05 indicating the level of significance.
  
  
  RESULTS
  The TIs in the first two time periods were comparable (P = 0.96); however, the difference between each of the first two time periods and the third (P1 vs. P3 and P2 vs. P3) was statistically significant (P < 0.001 for each).
  
  
  CONCLUSIONS
  The TI for the surgical management of endometrial cancer increased more significantly from 2007 to 2011 than in the previous eight years. The TI could be used as a performance indicator and as an incentive to promote minimally invasive surgery in the surgical management of endometrial cancer.
authors.affiliation: Department of Obstetrics and Gynecology, CHUQ-Hotel-Dieu de Québec, Quebec, QC.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Renaud
authors.affiliation: Department of Obstetrics and Gynecology, Laval University, Quebec, QC.
authors.forename: Marie
authors.initials: M
authors.lastname: Plante
authors.affiliation: Department of Obstetrics and Gynecology, CHUQ-Hotel-Dieu de Québec, Quebec, QC.
authors.forename: Michel
authors.initials: M
authors.lastname: Roy
mesh_terms: D003627:Data Interpretation, Statistical; D019468:Disease Management; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000706:statistics & numerical data; D007813:Laparotomy / Q000379:methods / Q000706:statistics & numerical data; D008501:Medical Records, Problem-Oriented; D019060:Minimally Invasive Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D018579:Patient Selection; D015203:Reproducibility of Results; D012107:Research Design; D013997:Time Factors