Learning curve estimates in robot-assisted surgery vary substantially between studies of the same procedure and are subject to considerable uncertainty¶
Claim · All claims
Evidence · 1 study · reviewr3·q2
Currency · newest study 2020 · not yet checked against its sources · not reviewed by a person
Subclaims¶
Reading the evidence codes
q is the design tier, i the impact, n the sample, and the kind with its r
the rigour judged within that kind: what each code means.
This claim: no standardized effect is recorded in observations/ for it yet, so no benchmark reading is possible.
q2 i? For the same procedure and metric, studies report divergent learning curve lengths; for robot-assisted distal pancreatectomy operating time, one study overcame the curve at 40 patients while two others had not overcome it within study periods of 11 and 83 patients. → Soomro N. A. 2020
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 the 27 duration-of-surgery studies reporting whether the learning curve was overcome, covering 22 unique procedures of which only five were supported by multiple studies. The review reports estimates "varied substantially between studies", citing the distal pancreatectomy contrast (40 versus not overcome in 11 and 83 patients).
"the number of patients required to overcome the learning curve for these varied substantially between studies. For example, three studies evaluated the learning curve for duration of surgery for robot‐assisted distal pancreatectomy. In one study47 the learning curve was overcome after 40 patients"
Discussion¶
Related Claims¶
- A plateau in performance does not necessarily equate to high-quality performance, so 'overcome' thresholds may misrepresent surgeon mastery
- Surgeons' previous experience and participation in structured training programmes are associated with shorter robot-assisted learning curves — related
- Methods and terminology used to define the point at which the robot-assisted learning curve is overcome are inconsistent and often lack statistical validation — related
- Time-based metrics dominate robot-assisted learning curve assessment, and recovery and safety metrics show substantially longer learning curves than operating time — related
- Individual progression of residents had a positive effect on patient outcomes, reported in seven studies — related
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