A Qualitative Web-Based Expert Opinion Analysis on the Adoption of Intraoperative CT and Navigation Systems in Spine Surgery
Notice bibliographique
Résumé
Introduction Intraoperative computed tomography (CT) and navigation systems have several potential uses in instrumented spine surgery and may decrease patient morbidity and complications leading to very significant cost-effectiveness implications. Despite these proposed advantages, its adaptation in centers across Canada, New Zealand, and Australia is not ubiquitous. The goal of this study is to identify facilitators and barriers to the adoption of intraoperative CT and navigation systems technology by spine surgeons. Materials and Methods A web-based survey was designed to explore spine surgeons' perceived advantages and disadvantages of the use of intraoperative CT and navigation systems, the learning curve of the technology, its teaching utility, and surgeon comfort level with the technology. Questions were based on the unified theory of acceptance and use of technology (UTAUT) model, which explores four main constructs that directly determine user acceptance and usage behavior: performance expectancy, effort expectancy, social influence, and facilitating conditions. The survey was distributed to surgeon members of the Canadian, New Zealand, and Australian Spine Societies. Participants were stratified into 2 groups: users and non-users of intra-operative CT and navigation, with a slight variability in questions answered by both groups based on applicability. Results A total of 53 surgeons completed the survey (34 Canadians, 16 New Zealanders, and 4 Australians). Overall, 24 of them are users of an intraoperative CT and navigation systems, and 29 are nonusers. The top three advantages identified by both users and nonusers in order of importance were more accurate screw placement, safer screw placement, and reassurance and confirmation of optimal screw placement. The top two disadvantages identified by both users and nonusers were the expense to purchase and maintain the equipment and the exposure of patient to radiation. The third main concern for nonusers is the time consumption associated with the use of this technology, whereas for surgeons who do use it, a disadvantage was that the use of intraoperative CT and navigation is technician dependent. Another concern revealed by the survey is after intra-operative CT and navigation use is implemented at an institution, surgeons think that the use of this technology may present an increased risk of infection (58.3% of surgeons who use it are concerned about this). Surgeons who have adopted this technology have done so primarily due to its clinical efficacy with screw placement, whereas surgeons who have not adopted intra-operative CT and navigation identify the cost of this technology as a limiting factor. Conclusion Spine surgeons recognize the benefit of using intraoperative CT and navigation systems to improve screw placement accuracy and safety. The cost associated with this new technology is the biggest deterrent to its widespread adoption in spine surgery centers in Canada, New Zealand, and Australia. Cost-benefit analysis evaluating the use of this technology would be useful in helping surgeons and health care centers make informed decisions about whether or not this investment is warranted.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,014 | 0,026 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,002 | 0,002 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».