Methods and terminology used to define the point at which the robot-assisted learning curve is overcome are inconsistent and often lack statistical validation¶

Claim · All claims
Evidence · 1 study (2 entries) · review r3 · q2
Currency · newest study 2020 · not yet checked against its sources · not reviewed by a person

Subclaims¶

q2 i? Performance thresholds used to define overcoming the learning curve varied (plateau, phase change, expert-set thresholds, unspecified), and in nine of 27 duration-of-surgery studies (33 per cent) no statistical or quantitative assessment beyond visual fit or qualitative description was reported. → Soomro N. A. 2020 q2 i? Performance terms were used inconsistently: in 13 of 14 studies employing them (93 per cent), at least one term described the point where the learning curve had been overcome, with 'proficiency' used in ten studies and 'competency' in five, sometimes interchangeably or with divergent definitions. → Soomro N. A. 2020 (2)

Evidence¶

Soomro N. A. 2020¶

Soomro N. A., Hashimoto D. A., Porteous A. J., Ridley C. J. A., Marsh W. J., Ditto R. and Roy S. (2020). Systematic review of learning curves in robot‐assisted surgery. BJS Open. https://doi.org/10.1002/bjs5.50235

q2 · i? · review · r3

Review synthesis of threshold definitions among the 27 studies defining whether the operating-time learning curve was overcome. The most common threshold was procedures to reach a plateau, but others used phase changes or expert-set thresholds, and "nine of the 27 studies (33 per cent)" used no statistical assessment.

"In nine of the 27 studies (33 per cent), no statistical or quantitative assessment of the learning curve was reported beyond visual fit or a qualitative description (data not reported)."

Soomro N. A. 2020 (2)¶

Soomro N. A., Hashimoto D. A., Porteous A. J., Ridley C. J. A., Marsh W. J., Ditto R. and Roy S. (2020). Systematic review of learning curves in robot‐assisted surgery. BJS Open. https://doi.org/10.1002/bjs5.50235

q2 · i? · review · r3

Review synthesis of terminology across studies using performance terms. 'Proficiency' marked the overcome point in ten studies and 'competency' in five; in the four studies reporting multiple terms, terms were either used interchangeably or assigned divergent definitions.

"In 13 of 14 studies (93 per cent) that employed performance terms, at least one term was used to describe the point where the learning curve had been overcome; ‘proficiency’ was used for this purpose in ten studies"

Discussion¶

Related Claims¶

• Time-based metrics dominate robot-assisted learning curve assessment, and recovery and safety metrics show substantially longer learning curves than operating time
• A plateau in performance does not necessarily equate to high-quality performance, so 'overcome' thresholds may misrepresent surgeon mastery — related
• Learning curve estimates in robot-assisted surgery vary substantially between studies of the same procedure and are subject to considerable uncertainty — related