Clinical consensus surveys were conducted among a panel of head and neck/reconstructive surgeons (N = 11). A content validity index for relevancy and clarity for each item was computed and adjusted for chance agreement (modified kappa, K). Items with K < 0.74 for relevancy (i.e., ratings of \"good\" or \"fair\") were eliminated.
Five out of nineteen terms scored K < 0.74. Eliminated terms included \"vascular compromise\"; \"cellulitis\"; \"surgical site abscess\"; \"malocclusion\"; and \"non- or mal-union.\" Terms that achieved consensus were \"total/partial free flap failure\"; \"free flap takeback\"; \"arterial thrombosis\"; \"venous thrombosis\"; \"revision of microvascular anastomosis\"; \"fistula\"; \"wound dehiscence\"; \"hematoma\"; \"seroma\"; \"partial skin graft failure\"; \"total skin graft failure\"; \"exposed hardware or bone\"; and \"hardware failure.\"
Standardized reporting would encourage multi-institutional research collaboration, larger scale quality improvement initiatives, the ability to set risk-adjusted benchmarks, and enhance education and communication.
在一组头颈部/重建外科医生中进行了临床共识调查(N=11)。计算了每个项目的相关性和清晰度的内容有效性指数,并根据机会协议进行了调整(修改后的kappa,K).相关性K<0.74的项目(即,“良好”或“公平”)的评级被取消。
19个学期中有5个得分为K<0.74。消除的术语包括“血管损害”;“蜂窝织炎”;“手术部位脓肿”;“错牙合”;和“无或不愈合”。\"达成共识的术语为\"完全/部分游离皮瓣失败\";\"游离皮瓣回收\";\"动脉血栓形成\";\"静脉血栓形成\";\"微血管吻合修正\";\"瘘管\";\"伤口裂开\";\"血肿\";\"血清\"部分植皮失败\";\"全植皮硬件\";\"“
标准化报告将鼓励多机构研究合作,更大规模的质量改进举措,设定风险调整基准的能力,加强教育和交流。