Abstract
Objective
To assess the reliability of peer-review of TURBT videos as a means to evaluate surgeon
skill and its relationship to detrusor sampling.
Methods
Urologists from an academic health system submitted TURBT videos in 2019. Ten blinded
peers evaluated each surgeon's performance using a 10-item scoring instrument to quantify
surgeon skill. Normalized composite skill scores for each surgeon were calculated
using peer ratings. For surgeons submitting videos, we retrospectively reviewed all
TURBT pathology results (2018-2019) to assess surgeon-specific detrusor sampling.
A hierarchical logistic regression model was fit to evaluate the association between
skill and detrusor sampling, adjusting for patient and surgeon factors.
Results
Surgeon skill scores and detrusor sampling rates were determined for 13 surgeons performing
245 TURBTs. Skill scores varied from -6.0 to 5.1 [mean: 0; standard deviation (SD):
2.40]. Muscle was sampled in 72% of cases, varying considerably across surgeons (mean:
64.5%; SD: 30.7%). Among 8 surgeons performing >5 TURBTs during the study period,
adjusted detrusor sampling rate was associated with sending separate deep specimens
(odds ratio [OR]: 1.97; 95% confidence interval [CI]: 1.02-3.81, P = .045) but not skill (OR: 0.81; 95% CI: 0.57-1.17, P = .191).
Conclusion
Surgeon skill was not associated with detrusor sampling, suggesting there may be other
drivers of variability of detrusor sampling in TURBT.
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Article info
Publication history
Published online: August 29, 2022
Accepted:
July 10,
2022
Received:
March 6,
2022
Footnotes
Funding Support: The authors acknowledge the support of the Dixon Translational Research Grants Initiative at Northwestern Medicine and the Northwestern University Clinical and Translational Sciences Institute (UL1 TR001422), which made possible design/conduct of the study, collection of data, and the management of data.
Data collection was made possible using REDCap electronic data capture tools hosted at the Northwestern University's Clinical and Translational Science Institute, funded in part by a Clinical and Translational Science Award (CTSA) grant from the National Institutes of Health (NIH) grant number UL1TR001422.
Identification
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© 2022 Published by Elsevier Inc.
