Development and validation of metrics for assessment of ultrasound-guided fascial block skills☆
Performance · Checklist score, lumbar and thoracic erector spinae injectionResult — go to the resultDifference 1.5 CI 1.0–2.5Authors' conclusion
An 11-point checklist developed through a modified Delphi process to provide best practice guidance for fascial plane injection showed construct validity in performing lumbar and thoracic erector spinae fascial plane injection in soft-embalmed Thiel cadavers.
Study context
- Population
- Operators performing ultrasound-guided lumbar and thoracic erector spinae and other fascial plane injections on soft-embalmed Thiel cadavers6 cadavers
- Participants
- 12 vs 12
- Comparison
- Experts vs novices performing fascial plane injections
- Expertsn = 12
- Novicesn = 12reference
- Outcome
- Construct validity of an 11-item checklist for lumbar and thoracic erector spinae fascial plane injection
Methodological detailsmodified Delphi process, blinded raters, soft-embalmed Thiel cadavers, 6 blinded expert raters examined 120 videos each, Delphi: 24 UK consultant regional anaesthetists, two iterations
- Modified Delphi process
- Blinded raters
- Soft-embalmed Thiel cadavers
- 6 blinded expert raters examined 120 videos each
- Delphi: 24 UK consultant regional anaesthetists, two iterations
Performance
As reported in the abstract
Difference
1.5
CI 1.0–2.5
P < 0.001
By group
Experts
8.0
median · IQR [range] 7.0-10.0 [1-11]
Novices
7.0
median · IQR [range] 5.0-9.0 [4-11]
Further findings
Checklist reliability (erector spinae plane injection)
- Internal consistency, mean
- 0.72 (95% CI 0.63-0.79)
- Interclass correlation
- 0.88 (95% CI 0.82-0.93)
Most difficult items
- Checklist: identifying the needle tip before advancing and always visualising the needle tip; Global rating scale (GRS): instrument handling and flow of procedure
Checklist vs GRS scores
- Checklist and GRS scores correlated
Generalisability (all fascial plane blocks, checklist and GRS)
- Rho (ρ2)
- 0.93-0.96
- Phi (ϕ)
- 0.84-0.87
- High reliability
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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