INTRODUCTION: Recommendations for assessing learning curves in surgery were published in 2001. This study aims to assess systematically all published learning curve studies in laparoscopic surgery, and determine the impact of these recommendations on the quality of the publication.
METHODS AND PROCEDURES: A systematic review was performed on all studies from 1996 assessing learning curves in laparoscopic surgery. Over 20 endpoints were extracted in the categories of study characteristics, statistical methods used, operator characteristics and variables used for analysis. Study quality was determined by the validated methodological index for non-randomized studies (MINORS) score, evaluated by 2 independent reviewers, and the journal impact factor. Logistic regression analysis was used to identify independent predictors of study quality.
RESULTS: 85 studies matched the selection criteria and reported on 23100 live procedures. 24% studies used no statistical methods, 60% used simple group comparisons. 31% used indirect measures to model learning curve, and 66% reported the operator experience, of which only 27% used this as a factor in their analysis. The inclusion of direct endpoints, operator experience, impact factor and MINORS score did not change significantly after 2001. In robotic surgery studies, the year of publication negatively influences the impact factor (p
Program Number: P254