Distinguishing surgical behavior by sequential pattern discovery.
Each surgical procedure is unique due to patient's and also surgeon's particularities. In this study, we propose a new approach to distinguish surgical behaviors between surgical sites, levels of expertise and individual surgeons thanks to a pattern discovery method.



The developed approach aims to distinguish surgical behaviors based on shared longest frequent sequential patterns between surgical process models. To allow clustering, we propose a new metric called SLFSP. The approach is validated by comparison with a clustering method using Dynamic Time Warping as a metric to characterize the similarity between surgical process models.



Our method outperformed the existing approach. It was able to make a perfect distinction between surgical sites (accuracy of 100%). We reached an accuracy superior to 90% and 85% for distinguishing levels of expertise and individual surgeons.



Clustering based on shared longest frequent sequential patterns outperformed the previous study based on time analysis.



The proposed method shows the feasibility of comparing surgical process models, not only by their duration but also by their structure of activities. Furthermore, patterns may show risky behaviors, which could be an interesting information for surgical training to prevent adverse events.
UGA/ CNRS/ INSERM, TIMC-IMAG UMR 5525, Grenoble F-38041, France; INSERM, UMR 1099, Rennes F-35000, France; Université de Rennes 1, LTSI, Rennes F-35000, France. Electronic address: arnaud.huaulme@univ-grenoble-alpes.fr.
Arnaud
A
Huaulmé
UGA/ CNRS/ INSERM, TIMC-IMAG UMR 5525, Grenoble F-38041, France.
Sandrine
S
Voros
INSERM, UMR 1099, Rennes F-35000, France; Université de Rennes 1, LTSI, Rennes F-35000, France; Department of Neurosurgery, Rennes University Hospital, 35000 Rennes, France.
Laurent
L
Riffaud
MIPS, University of Haute-Alsace, France.
Germain
G
Forestier
UGA/ CNRS/ INSERM, TIMC-IMAG UMR 5525, Grenoble F-38041, France; UGA/ CHU Grenoble/ INSERM, Centre d'Investigation Clinique - Innovation Technologique, CIT803, Grenoble F-38041, France.
Alexandre
A
Moreau-Gaudry
INSERM, UMR 1099, Rennes F-35000, France; Université de Rennes 1, LTSI, Rennes F-35000, France.
Pierre
P
Jannin
D002983:Clinical Competence; D016000:Cluster Analysis; D013502:General Surgery / Q000193:education* / Q000379:methods*; D006801:Humans; D008953:Models, Anatomic; D012306:Risk; D013514:Surgical Procedures, Operative; D013997:Time Factors
Pattern discovery; Surgical procedure; Surgical process model; Surgical skills