Crowdsourced assessment of surgical skill proficiency in cataract surgery

OBJECTIVE: To test whether crowdsourced lay raters can accurately assess cataract surgical skills. DESIGN: Two-armed study: independent cross-sectional and longitudinal cohorts. SETTING: Washington University Department of Ophthalmology. PARTICIPANTS AND METHODS: Sixteen cataract surgeons with varying experience levels submitted cataract surgery videos to be graded by 5 experts and 300+ crowdworkers masked to surgeon experience. Cross-sectional study: 50 videos from surgeons ranging from first-year resident to attending physician, pooled by years of training. Longitudinal study: 28 videos obtained at regular intervals as residents progressed through 180 cases. Surgical skill was graded using the modified Objective Structured Assessment of Technical Skill (mOSATS). Main outcome measures were overall technical performance, reliability indices, and correlation between expert and crowd mean scores. RESULTS: Experts demonstrated high interrater reliability and accurately predicted training level, establishing construct validity for the modified OSATS. Crowd scores were correlated with (r = 0.865, p \u3c 0.0001) but consistently higher than expert scores for first, second, and third-year residents (p \u3c 0.0001, paired t-test). Longer surgery duration negatively correlated with training level (r = -0.855, p \u3c 0.0001) and expert score (r = -0.927, p \u3c 0.0001). The longitudinal dataset reproduced cross-sectional study findings for crowd and expert comparisons. A regression equation transforming crowd score plus video length into expert score was derived from the cross-sectional dataset (r CONCLUSIONS: Crowdsourced rankings correlated with expert scores, but were not equivalent; crowd scores overestimated technical competency, especially for novice surgeons. A novel approach of adjusting crowd scores with surgery duration generated a more accurate predictive model for surgical skill. More studies are needed before crowdsourcing can be reliably used for assessing surgical proficiency

CHOMPTT (CubeSat Handling of Multisystem Precision Timing Transfer): From Concept to Launch Pad

Here we present the evolution of a student satellite mission: CHOMPTT (CubeSat Handling of Multisystem Precision Time Transfer), from its original concept as a candidate for the University NanoSatellite Program 8 (UNP8), to a spacecraft ready for launch in Fall of 2017 on ELaNa XIX (Educational Launch of Nanosatellites). The 3U CubeSat houses a 1 kg, 1U OPTI (Optical Precision Timing Instrument) payload, designed and built at the University of Florida, and a 1.5U EDSNNODeS-derived bus from NASA Ames Research Center. The OPTI payload comprises of: 1) a supervisor board that handles payload data, power regulation, and mode settings, 2) an optics assembly of six 1 cm retroreflectors and four laser beacon diodes for ground-tracking; and 3) two fully redundant timing channels, each consisting of: a chip-scale atomic clock, a microprocessor with clock counter, a picosecond event timer, and an avalanche photodetector (APD) with band-pass filter. Several iterations of OPTI have been developed, tested, and designed to achieve its current functionality and design a laboratory breadboard design, a 1.5U high altitude balloon design, engineering unit design, and its current flight unit design. In-lab testing of the current OPTI design indicates a short-term precision of 100 ps, equivalent to a range accuracy of 3 cm necessary to achieve our primary objective of 200 ps time transfer error, and a long-term timing accuracy of 20 ns over one orbit (1.5 hours). After the spacecraft reaches its nominal 500 km orbit at a 85 degree inclination, an experimental laser ranging facility at Kennedy Space Center in Florida, will track and emit 1064 nm nanosecond optical pulses at the CHOMPTT spacecraft. The laser pulses will then reflect off the retroreflector array mounted on the nadir face of CHOMPTT, and return the pulse to the laser ranging facility where the laser ranging facility will record the round-trip duration of the laser pulses. At the same time the pulse arrives at the spacecraft and is reflected by the array, an APD will record the arrival time of the pulses at the nanosatellite. By comparing the arrival of the pulse at the CubeSat and the duration of the round-trip of the laser pulse, the clock discrepancy between the ground and CubeSat atomic clocks can be determined, in addition to the CubeSats range from the facility. The design and verification of the flight version of CHOMPTT will be reviewed and an overview of the lifetime development and progression of CHOMPTT from the inception to launch pad will be presented

Predictive Factors of Research Productivity among Ophthalmology Residents: A Benchmark Analysis

Introduction Positive and negative associations between prior publications and future research productivity is described in other fields, but no such analysis exists for ophthalmology. We conducted a study to determine characteristics of residents exhibiting research productivity during residency. Methods Using San Francisco Match and Program Web sites, a roster of ophthalmology residents in 2019 to 2020 was compiled, and publication data was collected via PubMed and Google Scholar on a random sample of 100 third-year residents. Results The median number of publications generated by ophthalmology residents before residency is 2 (range 0–13). Thirty-seven, 23, and 40 residents had zero, one, and two or more papers published during residency, respectively, with a median of 1 (range 0–14). On univariate analysis, compared with residents who published zero or one paper, those who published ≥ 2 were more likely to have more preresidency publications (odds ratio [OR] 1.30; p = 0.005), attend a top-25 ranked residency program by multiple metrics including Doximity reputation (OR 4.92; p < 0.001), and have attended a top-25 ranked medical school program by U.S. News and World Report (OR 3.24; p = 0.03). However, on adjusted analyses, the only factor that remained significant for predicting publications in residency was whether the residency program attended was top 25 ranked (OR 3.54; p = 0.009). Discussion/Conclusion With the advent of the United States Medical Licensing Examination Step 1 pass/fail system, greater emphasis will be placed on other metrics, including research. This is the first benchmark analysis examining factors predictive of publication productivity in ophthalmology residents. Our study suggests that the residency program attended, not the medical school attended or prior publication history, plays an influential role in the number of publications produced during residency, highlighting the importance of factors to support research on the institutional level, such as mentorship and funding, rather than historical factors in research productivity by the resident