Metrics used to evaluate obstetric ultrasound skills on simulators: A systematic review.

Obstetric ultrasound simulators are now used for training and evaluating OB/GYN students but there is a lack of literature about evaluation metrics in this setting. In this literature review, we searched MEDLINE and the COCHRANE database using the keywords: (Obstetric OR Fetal) AND (Sonography OR Ultrasound) AND Simulation. Of a total of 263 studies screened, we selected nine articles from the title and the abstract in PubMed, in the past 5 years. Two more article were added from bibliographies. A total of 11 articles were therefore included. from which nine articles were selected from the title and the abstract in PubMed. Two more articles were added from the bibliographies For each study, data about the type of simulation, and the metrics (qualitative or quantitative) used for assessment were collected. The selection of studies shows that evaluation criteria for ultrasound training were qualitative metrics (binary success/fail exercise ; dexterity quoted by an external observer ; Objective Structured Assessment of Ultrasound Skills (OSAUS) Score ; quality of images according to Salomon's score) or quantitative criteria (Accuracy of Biometry - Simulator generated metrics). Most studies used a combination of both. To date, simulator metrics used to discriminate ultrasound skills are performance score quoted by external observers and image quality scoring. Whether probe trajectory metrics can be used to discriminate skills is unknown.

Pelvic floor disorders and sexuality in women with ovarian cancer: A systematic review.

INTRODUCTION: Pelvic floor disorders (PFD) are common conditions impacting quality of life and sexuality may worsen after ovarian cancer therapies. Our objective was to describe the prevalence of PFD and sexuality in women with ovarian cancer (OC). METHODS: We reviewed articles indexed in the MEDLINE database until June 2020 and selected articles assessing UI, POP, FI and sexual dysfunction in a population of women with OC. RESULTS: Of 360 articles, 18 were included: four assessed UI, two assessed POP, three FI, and 13 sexual dysfunction. PFD findings were highly heterogeneous due to the definitions used and the populations studied. The prevalence of any type of UI in patients with OC before treatment is around 50%, and about 17% report feeling a bulge in their vagina. These rates are similar to those reported in women without cancer. Similarly, the main post-treatment UI scores were not significantly different from women without cancer. Fecal incontinence has been less studied in women with OC but reported as affecting 4% of patients preoperatively and 16% postoperatively. About half of the women are sexually active after surgical treatment with high reported rates of dyspareunia (40-80%) and vaginal dryness (60-80%). Compared with healthy women, some authors found that OC patients had greater problems with loss of desire and poorer sexual function scores; other authors did not find a significant difference. CONCLUSIONS: While PFD seem to be common in women after treatment for OC, the rates are not higher than in the general population. Overall, there is a higher prevalence of UI and sexual dysfunction compared with bowel dysfunction. More prospective studies are needed to explore the impact of gynecologic cancers and their treatments on pelvic floor function and pelvic health-related quality of life.

Impact of Physician Expertise on Probe Trajectory During Obstetric Ultrasound: A Quantitative Approach for Skill Assessment.

INTRODUCTION: The objective of the study was to identify objective metrics to evaluate the significance of a sonographer's expertise on trajectories of ultrasound probe during obstetric ultrasound training procedures. METHODS: This prospective observational study was conducted at Rennes University Hospital, Department of Obstetrics and Gynecology. We evaluated a panel of sonographers (expert, intermediate, and novice) in performing 3 tasks (brain, heart, and spine) with an obstetric ultrasound simulator (Scantrainer; Medaphor, Cardiff, UK). The trajectories of the probe were logged and recorded by a custom data acquisition software. We computed metrics on the trajectories (duration, path length, average velocity, average acceleration, jerk, working volume) to compare the 3 groups and identify discriminating metrics. RESULTS: A total of 33 participants were enrolled: 5 experts, 12 intermediates, and 16 novices. Discriminatory metrics were observed among the 3 levels of expertise for duration, velocity, acceleration, and jerk for brain and spine tasks. Working volume was discriminatory for the brain and the heart task. Path length was discriminatory for the brain task. CONCLUSIONS: Our results suggest a relationship between the sonographer's level of expertise and probe trajectory metrics. Such measurements could be used as an indicator of sonographer proficiency and contribute to automatic analysis of probe trajectory to evaluate the quality of sonography and the sonographer.