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  • Examination of the Inter-rater Reliability of a Microanastomosis Assessment Scale

    Final Number:

    Youssef J. Hamade MD, MS; Mohammed S. Alghoul MD; Samer Zammar MD; Rami James N Aoun MD; Najib El Tecle MD; Tarek Youssef El Ahmadieh; Salah G. Aoun MD; Richard W. Byrne MD; Nathan R. Selden MD, PhD; James S. Harrop MD, FACS; Daniel K. Resnick MD, MS; Bernard R. Bendok MD, MSCI, FAANS, FACS

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: The Northwestern Objective Microanastomosis Assessment Tool (NOMAT) has been validated previously as a microanastomosis assessment scale, however, the inter-rater reliability has not been determined. Establishing inter-rater reliability is important if the scale is to be adopted beyond the initial study conditions.

    Methods: Data for this study was collected from two settings: Setting A: the initial site at Northwestern University where validation of the scale was undertaken, and Setting B: The 2014 Senior Society junior resident boot camp at Indiana University. In setting A, Neurosurgical residents completed an end-to-end microanastomosis and recordings of their performance were graded by two blinded faculty members, one vascular neurosurgeon (BRB) and one plastic surgeon (MSA), using the NOMAT scale. In setting B, first year neurosurgery residents performed an end-to-end anastomosis and their performance was graded by one faculty member (BRB) and two postdoctoral research fellows (YJH and NEE) using the NOMAT scale.

    Results: Setting A: There was high degree of agreement among the two faculty members as shown by the intraclass correlation coefficient 0.881 (CI = 0.779 - 0.936, p <0.05). Setting B: There was favorable inter-rater agreement between the faculty member and the two post-doctoral fellows (0.782, CI = 0.658 - 0.866, p < 0.05). The mean of total NOMAT scores was found to be 29.8 in setting A and 32.2 in setting B.

    Conclusions: Inter-rater reliability for the NOMAT scale appears high. Future course faculty could be screened for inter-rater reliability using recorded videos to assure fidelity of the rating scale in neurosurgical courses.

    Patient Care: Incorporating simulation modules with validated assessment scales help improve neurosurgery resident training. This will ultimately lead to improved patient care and better health outcomes.

    Learning Objectives: Determine the inter-rater reliability of the NOMAT scale


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