Un système de formation informatisé pour réaliser une ponction lombaire échoguidée sur des modèles de colonne vertébrale anormale: une étude randomisée contrôlée

Translated title of the contribution: Computerized training system for ultrasound-guided lumbar puncture on abnormal spine models: a randomized controlled trial

Zsuzsanna Keri, Devin Sydor, Tamas Ungi, Matthew S. Holden, Robert McGraw, Parvin Mousavi, Daniel P. Borschneck, Gabor Fichtinger, Melanie Jaeger

Research output: Contribution to journalArticle

Abstract

Purpose: A randomized controlled trial was carried out to determine whether Perk Tutor, a computerized training platform that displays an ultrasound image and real-time needle position in a three-dimensional (3D) anatomical model, would benefit residents learning ultrasound-guided lumbar puncture (LP) in simulation phantoms with abnormal spinal anatomy. Methods: Twenty-four residents were randomly assigned to either the Perk Tutor (P) or the Control (C) group and asked to perform an LP with ultrasound guidance on part-task trainers with spinal pathology. Group P was trained with the 3D display along with conventional ultrasound imaging, while Group C used conventional ultrasound only. Both groups were then tested solely with conventional ultrasound guidance on an abnormal spinal model not previously seen. We measured potential tissue damage, needle path in tissue, total procedure time, and needle insertion time. Procedural success rate was a secondary outcome. Results: The needle tracking measurements (expressed as median [interquartile range; IQR]) in Group P vs Group C revealed less potential tissue damage (39.7 [21.3-42.7] cm2vs 128.3 [50.3-208.2] cm2, respectively; difference 88.6; 95% confidence intervals [CI] 24.8 to 193.5; P = 0.01), a shorter needle path inside the tissue (426.0 [164.9-571.6] mm vs 629.7 [306.4-2,879.1] mm, respectively; difference 223.7; 95% CI 76.3 to 1,859.9; P = 0.02), and lower needle insertion time (30.3 [14.0-51.0] sec vs 59.1 [26.0-136.2] sec, respectively; difference 28.8; 95% CI 2.2 to 134.0; P = 0.05). Total procedure time and overall success rates between groups did not differ. Conclusion: Residents trained with augmented reality 3D visualization had better performance metrics on ultrasound-guided LP in pathological spine models.

Original languageFrench
Pages (from-to)777-784
Number of pages8
JournalCanadian Journal of Anesthesia
Volume62
Issue number7
DOIs
StatePublished - Mar 25 2015
Externally publishedYes

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Spinal Puncture
Needles
Spine
Randomized Controlled Trials
Confidence Intervals
Anatomic Models
Ultrasonography
Anatomy
Learning
Pathology
Control Groups

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Un système de formation informatisé pour réaliser une ponction lombaire échoguidée sur des modèles de colonne vertébrale anormale : une étude randomisée contrôlée. / Keri, Zsuzsanna; Sydor, Devin; Ungi, Tamas; Holden, Matthew S.; McGraw, Robert; Mousavi, Parvin; Borschneck, Daniel P.; Fichtinger, Gabor; Jaeger, Melanie.

In: Canadian Journal of Anesthesia, Vol. 62, No. 7, 25.03.2015, p. 777-784.

Research output: Contribution to journalArticle

Keri, Zsuzsanna ; Sydor, Devin ; Ungi, Tamas ; Holden, Matthew S. ; McGraw, Robert ; Mousavi, Parvin ; Borschneck, Daniel P. ; Fichtinger, Gabor ; Jaeger, Melanie. / Un système de formation informatisé pour réaliser une ponction lombaire échoguidée sur des modèles de colonne vertébrale anormale : une étude randomisée contrôlée. In: Canadian Journal of Anesthesia. 2015 ; Vol. 62, No. 7. pp. 777-784.
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abstract = "Purpose: A randomized controlled trial was carried out to determine whether Perk Tutor, a computerized training platform that displays an ultrasound image and real-time needle position in a three-dimensional (3D) anatomical model, would benefit residents learning ultrasound-guided lumbar puncture (LP) in simulation phantoms with abnormal spinal anatomy. Methods: Twenty-four residents were randomly assigned to either the Perk Tutor (P) or the Control (C) group and asked to perform an LP with ultrasound guidance on part-task trainers with spinal pathology. Group P was trained with the 3D display along with conventional ultrasound imaging, while Group C used conventional ultrasound only. Both groups were then tested solely with conventional ultrasound guidance on an abnormal spinal model not previously seen. We measured potential tissue damage, needle path in tissue, total procedure time, and needle insertion time. Procedural success rate was a secondary outcome. Results: The needle tracking measurements (expressed as median [interquartile range; IQR]) in Group P vs Group C revealed less potential tissue damage (39.7 [21.3-42.7] cm2vs 128.3 [50.3-208.2] cm2, respectively; difference 88.6; 95{\%} confidence intervals [CI] 24.8 to 193.5; P = 0.01), a shorter needle path inside the tissue (426.0 [164.9-571.6] mm vs 629.7 [306.4-2,879.1] mm, respectively; difference 223.7; 95{\%} CI 76.3 to 1,859.9; P = 0.02), and lower needle insertion time (30.3 [14.0-51.0] sec vs 59.1 [26.0-136.2] sec, respectively; difference 28.8; 95{\%} CI 2.2 to 134.0; P = 0.05). Total procedure time and overall success rates between groups did not differ. Conclusion: Residents trained with augmented reality 3D visualization had better performance metrics on ultrasound-guided LP in pathological spine models.",
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AU - Ungi, Tamas

AU - Holden, Matthew S.

AU - McGraw, Robert

AU - Mousavi, Parvin

AU - Borschneck, Daniel P.

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