Clinical Trials Study
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World J Gastrointest Endosc. May 16, 2014; 6(5): 193-199
Published online May 16, 2014. doi: 10.4253/wjge.v6.i5.193
Using motion capture to assess colonoscopy experience level
Morten Bo Svendsen, Louise Preisler, Jens Georg Hillingsoe, Lars Bo Svendsen, Lars Konge
Morten Bo Svendsen, Lars Konge, Centre for Clinical Education, University of Copenhagen and the Capital Region of Denmark, 2100 Copenhagen, Denmark
Louise Preisler, Jens Georg Hillingsoe, Lars Bo Svendsen, Department of Surgical Gastroenterology, Rigshospitalet and University of Copenhagen, 2100 Copenhagen, Denmark
Author contributions: Svendsen MB, Preisler L, Hillingsoe JG, Svendsen LB and Konge L designed the research; Svendsen MB, Preisler L, Hillingsoe JG and Konge L performed the research; Svendsen MB, Svendsen LB and Konge L analyzed the data; Svendsen MB, Preisler L, Hillingsoe JG, Svendsen LB and Konge L wrote the paper.
Correspondence to: Louise Preisler, MD, Department of Surgical Gastroenterology, Rigshospitalet and University of Copenhagen, Rigshospitalet, Blegdamsvej 7-9, 2100 Copenhagen, Denmark. louise@preisler.dk
Telephone: +45-35-458200 Fax: +45-35-452183
Received: November 25, 2013
Revised: February 17, 2014
Accepted: April 11, 2014
Published online: May 16, 2014
Processing time: 176 Days and 6.9 Hours
Abstract

AIM: To study technical skills of colonoscopists using a Microsoft Kinect™ for motion analysis to develop a tool to guide colonoscopy education.

RESULTS: Ten experienced endoscopists (gastroenterologists, n = 2; colorectal surgeons, n = 8) and 11 novices participated in the study. A Microsoft Kinect™ recorded the movements of the participants during the insertion of the colonoscope. We used a modified script from Microsoft to record skeletal data. Data were saved and later transferred to MatLab for analysis and the calculation of statistics. The test was performed on a physical model, specifically the “Kagaku Colonoscope Training Model” (Kyoto Kagaku Co. Ltd, Kyoto, Japan). After the introduction to the scope and colonoscopy model, the test was performed. Seven metrics were analyzed to find discriminative motion patterns between the novice and experienced endoscopists: hand distance from gurney, number of times the right hand was used to control the small wheel of the colonoscope, angulation of elbows, position of hands in relation to body posture, angulation of body posture in relation to the anus, mean distance between the hands and percentage of time the hands were approximated to each other.

RESULTS: Four of the seven metrics showed discriminatory ability: mean distance between hands [45 cm for experienced endoscopists (SD 2) vs 37 cm for novice endoscopists (SD 6)], percentage of time in which the two hands were within 25 cm of each other [5% for experienced endoscopists (SD 4) vs 12% for novice endoscopists (SD 9)], the level of the right hand below the sighting line (z-axis) (25 cm for experienced endoscopists vs 36 cm for novice endoscopists, P < 0.05) and the level of the left hand below the z-axis (6 cm for experienced endoscopists vs 15 cm for novice endoscopists, P < 0.05). By plotting the distributions of the percentages for each group, we determined the best discriminatory value between the groups. A pass score was set at the intersection of the distributions, and the consequences of the standard were explored for each test. By using the contrasting group method, we showed a discriminatory value of Z = 1.51 to be the pass/fail value of the data showing discriminatory ability. The pass score allowed all ten experienced endoscopists as well as five novice endoscopists to pass the test.

CONCLUSION: Identified metrics can be used to discriminate between experienced and novice endoscopists and to provide non-biased feedback. Whether it is possible to use this tool to train novices in a clinical setting requires further study.

Keywords: Colonoscopy; Assessment; Simulation; Motion-capture; Motion-analysis

Core tip: Motion capture for motion analysis can be used to discriminate between experienced and novice performers of colonoscopy. We analyzed the motion patterns of the technical procedure of inserting the colonoscope from anus to cecum in a simulation set-up. The technical differences between novice and experienced endoscopists observed in this study are important because they can help shape skills that will lead to competence in colonoscopy. In the future, this technique might be useful in the training and education of future colonoscopists in a clinical setting.