title: Man versus Machine: Software Training for Surgeons-An Objective Evaluation of Human and Computer-Based Training Tools for Cataract Surgical Performance.
abstract: This study aimed to address two queries: firstly, the relationship between two cataract surgical feedback tools for training, one human and one software based, and, secondly, evaluating microscope control during phacoemulsification using the software. Videos of surgeons with varying experience were enrolled and independently scored with the validated PhacoTrack motion capture software and the Objective Structured Assessment of Cataract Surgical Skill (OSACCS) human scoring tool. Microscope centration and path length travelled were also evaluated with the PhacoTrack software. Twenty-two videos correlated PhacoTrack motion capture with OSACCS. The PhacoTrack path length, number of movements, and total procedure time were found to have high levels of Spearman's rank correlation of -0.6792619 (p= 0.001), -0.6652021 (p= 0.002), and -0.771529 (p= 0001), respectively, with OSACCS. Sixty-two videos evaluated microscope camera control. Novice surgeons had their camera off the pupil centre at a far greater mean distance (SD) of 6.9 (3.3) mm, compared with experts of 3.6 (1.6) mm (p≪ 0.05). The expert surgeons maintained good microscope camera control and limited total pupil path length travelled 2512 (1031) mm compared with novices of 4049 (2709) mm (p≪ 0.05). Good agreement between human and machine quantified measurements of surgical skill exists. Our results demonstrate that surrogate markers for camera control are predictors of surgical skills.
authors.affiliation: Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK.
authors.forename: Nizar
authors.identifier: 0000-0002-6446-9639
authors.initials: N
authors.lastname: Din
authors.affiliation: Department of Computer Science, University Of Surrey, Guildford, UK.
authors.forename: Phillip
authors.initials: P
authors.lastname: Smith
authors.affiliation: Moorfields Eye Hospital, Bedford, UK.
authors.forename: Krisztina
authors.identifier: 0000-0001-5174-4315
authors.initials: K
authors.lastname: Emeriewen
authors.affiliation: Moorfields Eye Hospital, Bedford, UK.
authors.forename: Anant
authors.initials: A
authors.lastname: Sharma
authors.affiliation: NYU Langone Medical Center, New York, USA.
authors.forename: Simon
authors.initials: S
authors.lastname: Jones
authors.affiliation: Royal Free Hospital, London, UK.
authors.forename: James
authors.identifier: 0000-0002-8207-2678
authors.initials: J
authors.lastname: Wawrzynski
authors.affiliation: Department of Computer Science, University Of Surrey, Guildford, UK.
authors.forename: Hongying
authors.identifier: 0000-0003-2534-737X
authors.initials: H
authors.lastname: Tang
authors.affiliation: Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Sullivan
authors.affiliation: Moorfields Eye Hospital, Bedford, UK.
authors.forename: Silvestro
authors.identifier: 0000-0002-7624-3880
authors.initials: S
authors.lastname: Caputo
authors.affiliation: Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK; Department of Computer Science, University Of Surrey, Guildford, UK; NIHR Biomedical Research Centre at Moorfields Eye Hospital and the UCL Institute of Ophthalmology, London, UK.
authors.forename: George M
authors.identifier: 0000-0001-9113-4423
authors.initials: GM
authors.lastname: Saleh