Judgment analysis: a method for quantitative evaluation of trainee surgeons’ judgments of surgical risk

Abstract Background Surgical judgment and decision making require valid methods of assessment. The aim of this study was to evaluate the use of judgment analysis as a technique for quantitative evaluation of surgeons’ risk estimates. Methods Thirty trainee surgeons’ estimates of conversion risk in l...

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Bibliographic Details
Published in:The American journal of surgery 2008-02, Vol.195 (2), p.183-188
Main Authors: Jacklin, Ros, M.B.B.S., M.A., M.R.C.S, Sevdalis, Nick, B.Sc., M.Sc., Ph.D, Harries, Clare, B.Sc., Ph.D, Darzi, Ara, M.B.B.S., M.D, Vincent, Charles, B.A., M.Phil., Ph.D
Format: Article
Language:English
Subjects:
Abdomen
Abdominal surgery
Adult
Biological and medical sciences
Cholecystectomy - education
Cholecystectomy - methods
Cholecystectomy, Laparoscopic - education
Cholecystectomy, Laparoscopic - methods
Clinical Competence
Comorbidity
Decision Making
Education, Medical, Graduate
Evaluation Studies as Topic
Feedback
Female
Gallbladder
Gallbladder diseases
Gallstones
General aspects
Health participants
Human performance
Humans
Judgment
Judgment analysis
Male
Medical Errors - prevention & control
Medical sciences
Models, Theoretical
Mortality
Patients
Program Evaluation
Public health. Hygiene
Public health. Hygiene-occupational medicine
Reproducibility of Results
Risk
Risk Assessment
Sensitivity and Specificity
Studies
Surgery
Surgical outcomes
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Summary:Abstract Background Surgical judgment and decision making require valid methods of assessment. The aim of this study was to evaluate the use of judgment analysis as a technique for quantitative evaluation of surgeons’ risk estimates. Methods Thirty trainee surgeons’ estimates of conversion risk in laparoscopic cholecystectomy were investigated using judgment analysis. Hypothetical cases were created, differing in relevant risk factors. Twenty repeat cases were incorporated to test for reliability. Surgeons’ estimates were compared with an outcome-derived gold standard from the published literature. Results The mean reliability was .77 (range, .47–.98), and regression models indicating the weighting of variables had a mean adjusted R2 value of .53 (range, .12–.76). Variables were subject to wide variation in weighting. The mean correlation to the gold standard model was .48 (range, .08–.72). Conclusions Judgment analysis allows detailed quantitative evaluation of the consistency of surgeons’ risk estimates and the influence of different variables on them. Comparison with a gold standard model enables accuracy to be measured.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2007.09.031