The role of structured reporting and structured operation planning in functional endoscopic sinus surgery

Computed tomography (CT) scans represent the gold standard in the planning of functional endoscopic sinus surgeries (FESS). Yet, radiologists and otolaryngologists have different perspectives on these scans. In general, residents often struggle with aspects involved in both reporting and operation planning. The aim of this study was to compare the completeness of structured reports (SR) of preoperative CT images and structured operation planning (SOP) to conventional reports (CR) and conventional operation planning (COP) to potentially improve future treatment decisions on an individual level. In total, 30 preoperative CT scans obtained for surgical planning of patients scheduled for FESS were evaluated using SR and CR by radiology residents. Subsequently, otolaryngology residents performed a COP using free texts and a SOP using a specific template. All radiology reports and operation plannings were evaluated by two experienced FESS surgeons regarding their completeness for surgical planning. User satisfaction of otolaryngology residents was assessed by using visual analogue scales. Overall radiology report completeness was significantly higher using SRs regarding surgically important structures compared to CRs (84.4 vs. 22.0%, p<0.001). SOPs produced significantly higher completeness ratings (97% vs. 39.4%, p<0.001) regarding pathologies and anatomical variances. Moreover, time efficiency was not significantly impaired by implementation of SR (148 s vs. 160 s, p = 0.61) and user satisfaction was significantly higher for SOP (VAS 8.1 vs. 4.1, p<0.001). Implementation of SR and SOP results in a significantly increased completeness of radiology reports and operation planning for FESS. Consequently, the combination of both facilitates surgical planning and may decrease potential risks during FESS

Cost-benefit analyses of usability tests in medicine

Der Einsatz medizintechnischer Geräte (MTG) leistet heutzutage einen wichtigen Beitrag zur Behandlung von Patienten. Ihre Anwendung muss effiziente und sichere Arbeitsabläufe für Patienten und Personal gewährleisten, was den steigenden Stellenwert der Gebrauchstauglichkeit von MTG verdeutlicht. Die vorliegende Arbeit untersuchte das Verhältnis der Kosten von Gebrauchstauglichkeitstests (GT) zu ihrem Nutzen für Hersteller, Kliniken und Endnutzer. Auf Grundlage des GT eines Shavers (Medtronic, XPS 3000) und eines digitalen Dokumentationssystems (Conmed/Linvatec, VP 1500) mit 10 Probanden wurde hierzu eine Kosten-Nutzen-Analyse durchgeführt. Es zeigte sich, dass Hersteller durch Steigerung der Gebrauchstauglichkeit ihrer Produkte Schulungs-, Support- und Servicekosten senken und den Absatz steigern könnten. Kliniken könnten einerseits klinikeigene Geräte gezielt evaluieren, oder Gebrauchstauglichkeitstests als valide und reliable Grundlage für Kaufentscheidungen zu Rate ziehen. Durch gezielte nachträgliche Schulungsmaßnahmen bei klinikeigenen Geräten oder optimale Kaufentscheidungen im Voraus könnte die Produktivität medizinischer Arbeitsabläufe und die Patientensicherheit erhöht werden. Die Endnutzer würden durch eine Reduktion von Bedienfehlern, einer Erhöhung der Benutzerzufriedenheit und weiteren indirekten Vorteilen profitieren. Die Kosten des durchgeführten GT von etwa 20.000 € könnten sich schon im Laufe eines Jahres durch die finanziellen Benefits amortisieren. Alternative Verfahren zur Gebrauchstauglichkeitsevaluation erscheinen zwar kostengünstiger erreichen aber nicht die Qualität der Ergebnisse eines GT. Für alle untersuchten Parteien ergab die Durchführung von GT in der Kosten-Nutzen-Analyse eine Verbesserung nach Pareto. Höhere Gebrauchs-tauglichkeit von MTG ist zu fördern, da alle beteiligten Parteien und vor allem die Patienten davon profitieren.The use of medical devices (MTG) today makes an important contribution to the treatment of patients. Applications and work procedures must be efficient and safe to ensure the security of patients' and staff. The present study examined the relationship between the costs of usability testing (GT) to its benefit to manufacturers, hospitals and end users. Based on the GT of a shaver (Medtronic, XPS 3000) and a digital documentation system (Conmed / Linvatec, VP 1500) 10 subjects were involved in this cost-benefit analysis. It could be shown that manufacturers increasing the usability of their products could reduce the costs of product training, support and service and increase sales. Hospitals could specifically evaluate equipment, or do usability tests as valid and reliable basis for decisions before buying new devices. This could increase productivity of medical workflows and patient safety. The end user would benefit by a reduction of errors in usage, an increase in user satisfaction and other indirect benefits. The cost of the performed GT of about 20,000 € could have been recouped within a year by the financial benefits. Alternative methods for usability evaluation appear less cost intensive but the results differ in quality. For all the parties in the cost-benefit analysis the implementation of GT resulted in a Pareto improvement. Greater usability for MTG must be achieved, as all parties involved and especially the patients benefit from it