NDLI: Markov Model Assessment of Subjects' Clinical Skill Using the E-Pelvis Physical Simulator

Content Provider	IEEE Xplore Digital Library
Author	Mackel, T.R. Rosen, J. Pugh, C.M.
Copyright Year	1964
Abstract	Inherent difficulties evaluating clinical competence of physicians has led to the widespread use of subjective skill assessment techniques. Inspired by an analogy between spoken language and surgical procedure, a generalized methodology using Markov models (MMs), independent of the modality under study, was developed. The methodology applied to an endoscopic experiment in "Generalized approach for modeling minimally invasive surgery as a stochastic process using a discrete Markov model" by J. Rosen et al. (IEEE Trans. Biomed. Eng., Vol. 53, No. 3, pp. 399-413, Mar. 2006) is modified and applied to data collected with the E-Pelvis physical simulator. The simulator incorporates five contact pressure sensors located in key anatomical landmarks. Two 32-state fully connected MMs are used, one for each skill level. Each state corresponds to a unique five-dimensional signature of contact pressures. Statistical distances measured between models representing subjects with different skill levels are sensitive enough to provide an objective measure of medical skill level. The method was tested with 41 expert subjects and 41 novice subjects in addition to the 30 subjects used for training the MM. Of the 82 subjects, 76 (92%) were classified correctly. Unique state transitions as well as pressure magnitudes for corresponding states were found to be skill dependent. The "white box" nature of the model provides insight into the examination process performed.
Sponsorship	IEEE Engineering in Medicine and Biology Society
Page Count	9
File Size	1765691
Starting Page	2133
Ending Page	2141
File Format	PDF
ISSN	00189294
Volume Number	54
Issue Number	12
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	2007-12-01
Publisher Place	U.S.A.
Access Restriction	One Nation One Subscription (ONOS)
Rights Holder	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Subject Keyword	Hidden Markov models Medical simulation Natural languages Minimally invasive surgery Biomedical measurements Medical treatment Medical robotics Automatic speech recognition Jacobian matrices Stochastic processes skill assessment Classification E-Pelvis Markov model (MM) pressure sensing
Content Type	Text
Resource Type	Article
Subject	Biomedical Engineering

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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