Assessment of Competence in EVAR Procedures: A Novel Rating Scale Developed by the Delphi Technique

Research output: Contribution to journalArticle

Abstract

OBJECTIVE/BACKGROUND: To develop a procedure specific global rating scale for assessment of operator competence in endovascular aortic repair (EVAR).

METHODS: A Delphi approach was used to achieve expert consensus. A panel of 32 international experts (median 300 EVAR procedures, range 200-3000) from vascular surgery (n = 21) and radiology (n = 11) was established. The first Delphi round was based on a review of endovascular skills assessment papers, stent graft instructions for use, and structured interviews. It led to a primary pool of 83 items that were formulated as global rating scale items with tentative anchors. Iterative Delphi rounds were executed. The panellists rated the importance of each item on a 5 point Likert scale. Consensus was defined as 80% of the panel rating an item 4 or 5 in the primary round and 90% in subsequent rounds. Consensus on the final assessment tool was defined as Cronbach's alpha > .8 after a minimum of three rounds.

RESULTS: Thirty-two of 35 invited experts participated. Three rounds of surveys were completed with a completion rate of 100% in the first two rounds and 91% in round three. The 83 primary assessment items were supplemented with five items suggested by the panel and reduced to seven pivotal assessment items that reached consensus, Cronbach's alpha = 0.82. The seven item rating scale covers key elements of competence in EVAR stent placement and deployment. Each item has well defined grades with explicit anchors at unacceptable, acceptable, and superior performance on a 5 point Likert scale.

CONCLUSION: The Delphi methodology allowed for international consensus on a new procedure specific global rating scale for assessment of competence in EVAR. The resulting scale, EndoVascular Aortic Repair Assessment of Technical Expertise (EVARATE), represents key elements in the procedure. EVARATE constitutes an assessment tool for providing structured feedback to endovascular operators in training.

Details

Authors
  • M Strøm
  • L Lönn
  • B Bech
  • T V Schroeder
  • L Konge
  • “EVARATE Delphi Panel”
External organisations
  • University of Copenhagen
  • Copenhagen University Hospital
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • Adult, Aged, Aortic Aneurysm, Abdominal, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Clinical Competence, Consensus, Delphi Technique, Endovascular Procedures, Female, Humans, Male, Middle Aged, Process Assessment (Health Care), Quality Indicators, Health Care, Stents, Task Performance and Analysis, Treatment Outcome, Journal Article
Original languageEnglish
Pages (from-to)34-41
Number of pages8
JournalEuropean journal of vascular and endovascular surgery
Volume54
Issue number1
Publication statusPublished - 2017 Jul
Publication categoryResearch
Peer-reviewedYes
Externally publishedYes