title: Video recording of the operating room--is anonymity possible?
abstract: BACKGROUND
  Video recording in the operating room (OR) has many potential applications for research, quality improvement, and education. Routine video recording is limited by patient and staff privacy concerns, but this may be overcome by creating videos that are deidentified but still retain sufficient video data for intended applications. It is unknown what effect video processing may have on staff perceptions of identifiability in video recordings; this study was designed to investigate this effect.
  
  
  METHODS
  We presented OR staff members with short clips of the same staged surgical procedure, each representing different data formats or processing (unaltered video, blurred faces, infrared, and point clouds). Staff rated each video on a Likert scale (1 = anonymous, "no one could identify me"; 10 = not anonymous, "it would be easy to identify me) and provided qualitative comments.
  
  
  RESULTS
  Eighty-three staff members agreed to participate. The mean response for the unaltered, blurred faces, infrared, and point cloud videos were 7.05, 3.75, 5.77, and 1.41, respectively (all P < 0.001), demonstrating that postprocessing methods impact perceived anonymity. Staff roles (surgeons versus anesthesiologists versus nurses) were not significantly associated perceptions of identifiability (P ≥ 0.16).
  
  
  CONCLUSIONS
  This study demonstrates that surgical video postprocessing affects OR staff members' perceptions of anonymity and that it is possible to produce videos that retain details about surgical activity while still being perceived as anonymous. These findings are highly relevant to any study that uses video for quality improvement or health care research by providing the first normative data on "deidentification."
authors.affiliation: Department of Surgery, Operative Performance Research Institute, University of Chicago, Chicago, Illinois; Division of Biological Sciences, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.
authors.forename: Megan R
authors.initials: MR
authors.lastname: Silas
authors.affiliation: Department of Surgery, Operative Performance Research Institute, University of Chicago, Chicago, Illinois; Department of Surgery, University of Chicago, Chicago, Illinois.
authors.forename: Philippe
authors.initials: P
authors.lastname: Grassia
authors.affiliation: Department of Surgery, Operative Performance Research Institute, University of Chicago, Chicago, Illinois; Department of Surgery, University of Chicago, Chicago, Illinois. Electronic address: alangerm@surgery.bsd.uchicago.edu.
authors.forename: Alexander
authors.initials: A
authors.lastname: Langerman
mesh_terms: D001291:Attitude of Health Personnel; D002641:Chicago; D002983:Clinical Competence; D003219:Confidentiality; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D009873:Operating Rooms; D011785:Quality Assurance, Health Care / Q000379:methods*; D058996:Quality Improvement; D013514:Surgical Procedures, Operative / Q000592:standards*; D014741:Video Recording
keywords: Deidentification; Medical ethics; Performance monitoring; Privacy; Video recording; Video-based research