Preliminary stage in the development of an artificial intelligence algorithm: variations between 100 surgeons in phase annotation in a video of internal fixation of distal radius fracture
Résumé
Introduction: In order to be used naturally and widely, an artificial intelligence algorithm of phase detection in surgical videos presupposes an expert consensus defining phases.
Objectives: The aim of the present study was to seek consensus in defining the various phases of a surgical technique in wrist traumatology.
Methods: Three thousand two hundred and twenty-nine surgeons were sent a video showing anterior plate fixation of the distal radius and a questionnaire on the number of phases they distinguished and the visual cues signaling the beginning of each phase. Three experimenters predefined the number of phases (5: installation, approach, fixation, verification, closure) and sub-phases (3a: introduction of plate; 3b: positioning distal screws; 3c: positioning proximal screws) and the cues signaling the beginning of each. The numbers of the responses per item were collected.
Results: Only 216 (6.7%) surgeons opened the questionnaire, and 100 answered all questions (3.1%). Most respondents claimed 5/5 expertise. Number of phases identified ranged between 3 and 10. More than two-thirds of respondents identified the same phase cue as defined by the 3 experimenters in most cases, except for "verification" and "positioning proximal screws".
Discussion: Surgical procedures comprise a succession of phases, the beginning or end of which can be defined by a precise visual cue on video, either beginning with the appearance of the cue or the disappearance of the cue defining the preceding phase.
Conclusion: These cues need to be defined very precisely before attempting manual annotation of surgical videos in order to develop an artificial intelligence algorithm.
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