Self-guided training for deep brain stimulation planning using objective assessment
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Deep brain stimulation (DBS) is an increasingly common treatment for neurodegenerative diseases. Neurosurgeons must have thorough procedural, anatomical, and functional knowledge to plan electrode trajectories and thus ensure treatment efficacy and patient safety. Developing this knowledge requires extensive training. We propose a training approach with objective assessment of neurosurgeon proficiency in DBS planning.
To assess proficiency, we propose analyzing both the viability of the planned trajectory and the manner in which the operator arrived at the trajectory. To improve understanding, we suggest a self-guided training course for DBS planning using real-time feedback. To validate the proposed measures of proficiency and training course, two experts and six novices followed the training course, and we monitored their proficiency measures throughout.
At baseline, experts planned higher quality trajectories and did so more efficiently. As novices progressed through the training course, their proficiency measures increased significantly, trending toward expert measures.
We developed and validated measures which reliably discriminate proficiency levels. These measures are integrated into a training course, which quantitatively improves trainee performance. The proposed training course can be used to improve trainees’ proficiency, and the quantitative measures allow trainees’ progress to be monitored.
KeywordsDeep brain stimulation Objective skill assessment Simulation-based training
Matthew S. Holden was supported by the Natural Sciences and Engineering Research Council (NSERC) Canada Graduate Scholarship (Grant No. CGSD3-460098-2014). Travel was supported by the Mitacs Globalink Research Award—Campus France and the Rennes Metropole Mobility Grant. Gabor Fichtinger was supported as a Cancer Care Ontario Research Chair in Cancer Imaging. This work was financially supported as a Collaborative Health Research Project (CHRP #127797), a joint initiative between the Natural Sciences and Engineering Research Council of Canada (NSERC) and the Canadian Institutes of Health Research (CIHR).
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
All participation was voluntary. Written informed consent was obtained from all participants in this study.
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