Validation studies of virtual reality simulation performance metrics for mechanical thrombectomy in ischemic stroke

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dc.contributor.author Crossley, Robert
dc.contributor.author Liebig, Thomas
dc.contributor.author Holtmannspoetter, Markus
dc.contributor.author Lindkvist, Johan
dc.contributor.author Henn, Pat
dc.contributor.author Lonn, Lars
dc.contributor.author Gallagher, Anthony G.
dc.date.accessioned 2019-03-11T13:03:48Z
dc.date.available 2019-03-11T13:03:48Z
dc.date.issued 2018
dc.identifier.citation Crossley, R., Liebig, T., Holtmannspoetter, M., Lindkvist, J., Henn, P., Lonn, L. and Gallagher, A.G., 2019. Validation studies of virtual reality simulation performance metrics for mechanical thrombectomy in ischemic stroke. Journal of neurointerventional surgery, 014510 (7pp.). DOI: 10.1136/neurintsurg-2018-014510 en
dc.identifier.startpage 1 en
dc.identifier.endpage 7 en
dc.identifier.issn 1759-8478
dc.identifier.issn 1759-8486
dc.identifier.uri http://hdl.handle.net/10468/7602
dc.identifier.doi 10.1136/neurintsurg-2018-014510
dc.description.abstract Introduction: Mechanical thrombectomy (MT) has transformed the treatment of ischemic stroke. However, patient access to MT may be limited due to a shortage of doctors specifically trained to perform MT. The studies reported here were done to (1) develop, operationally define, and seek consensus from procedure experts on the metrics which best characterize a reference procedure for the performance of an MT for ischemic stroke and (2) evaluate their construct validity when implemented in a virtual reality (VR) simulation. Methods: In study 1, the metrics for a reference approach to an MT procedure for ischemic stroke of 10 phases, 46 steps, and 56 errors and critical errors, were presented to an international Delphi panel of 21 consultant level interventional neuroradiologists (INRs). In study 2, the metrics were used to assess 8 expert and 10 novice INRs performing a VR simulated routine MT procedure. Results: In study 1, the Delphi panel reached consensus on the appropriateness of the procedure metrics for a reference approach to MT in ischemic stroke. Group differences in median scores in study 2 demonstrated that experienced INRs performed the case 19% faster (P=0.029), completed 40% more procedure phases (P=0.009), 20% more steps (P=0.012), and made 42% fewer errors (P=0.016) than the novice group. Conclusions: The international Delphi panel agreed metrics implemented in a VR simulation of MT distinguished between the computer scored procedure performance of INR experts and novices. The studies reported here support the demonstration of face, content, and construct validity of the MT metrics. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BMJ Publishing Group en
dc.relation.uri https://jnis.bmj.com/content/neurintsurg/early/2019/01/17/neurintsurg-2018-014510.full.pdf
dc.rights © Author(s) (or their employer(s)) 2018. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Ischemic stroke en
dc.subject Mechanical thrombectomy en
dc.subject Virtual reality simulation en
dc.title Validation studies of virtual reality simulation performance metrics for mechanical thrombectomy in ischemic stroke en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Patrick Henn, Department of Medicine, University College Cork, Cork, Ireland. +353-21-490-3000 Email: p.henn@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder VINNOVA en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Journal of NeuroInterventional Surgery en
dc.internal.IRISemailaddress p.henn@ucc.ie
dc.identifier.articleid 014510
dc.internal.bibliocheck Check for volume, issue numbers


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© Author(s) (or their employer(s)) 2018. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Except where otherwise noted, this item's license is described as © Author(s) (or their employer(s)) 2018. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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