Validation of subjective rating scales for assessment of surgical workspace during laparoscopy G. G. Nervil 1 , R. Medici 1 , J. L. D. Thomsen 1 , A. K. Staehr-Rye 1 , S. Asadzadeh 2 , J. Rosenberg 2 , M. R. G€ atke 1 and M. V. Madsen 1 1 Department of Anesthesiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark 2 Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark Correspondence G. G. Nervil, Department of Anesthesiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark E-mail: gustavnervil@gmail.com Conflict of Interest Dr. Nervil reports grants from Merck Sharp & Dohme Corp during the conduct of the study. Dr. Medici reports grants from Merck Sharp & Dohme Corp during the conduct of the study and grants from Merck Sharp & Dohme Corp outside the submitted work. Dr. Thomsen reports grants from Merck Sharpe and Dohme outside the submitted work. Dr. Staehr-Rye reports grants from Merck Sharp & Dohme Corp during the conduct of the study. Dr. Asadzadeh has nothing to disclose. Dr. Rosenberg reports personal fees from Merck and grants and personal fees from Bard outside the submitted work. Dr. G€ atke reports grants from Merck Sharp & Dohme Corp during the conduct of the study. Dr. Vested Madsen reports grants from Merck Sharp & Dohme Corp during the conduct of the study and grants from Merck Sharp & Dohme Corp outside the submitted work. Funding The study was supported in part by a research grant from Investigator-Initiated Studies Program of MSD. The opinions expressed in this study are those of the authors and do not necessarily represent those of MSD. Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT02545270?term= NCT02545270&rank=1 Accepted 9 September 2017; submission 17 May 2017. Citation Nervil GG, Medici R, Thomsen JLD, Staehr-Rye AK, Asadzadeh S, Rosenberg J, G€ atke MR, Madsen MV. Validation of subjective rating scales for assessment of surgical workspace during laparoscopy. Acta Anaesthesiologica Scandinavica 2017. doi: 10.1111/aas.13001 Background: Recently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra-abdominal pressure, level of muscle relaxation or body position, typically evaluated by surgeons using subjective rating scales. We aimed to validate two rating scales by having surgeons assess surgical workspace in video sequences recorded during laparoscopic surgery. Method: Video sequences were obtained from laparoscopic pro- cedures. Eight experienced surgeons assessed the video sequences on a categorical 5-point scale and a numerical 10-point rating scale. Intraclass correlations coefficients (ICC) and 95% confidence intervals (CI) were calculated for intra- and inter-rater reliability. Results: The 5-point rating scale had an intra-rater ICC of 0.76 (0.69; 0.83) and an inter-rater ICC of 0.57 (0.45; 0.68), correspond- ing to excellent and fair reliability, respectively. The 10-point scale had an intra-rater ICC of 0.86 (0.82; 0.89) and an inter-rater ICC of 0.54 (0.39; 0.68), corresponding to excellent and fair as well. All surgeons used the full range of the 5-point scale, but only one surgeon used the full range of the 10-point scale. Conclusion: In conclusion, both scales showed excellent intra- rater and fair inter-rater reliability for assessing surgical work- space in laparoscopy. The 5-point surgical rating scale had all categories employed by all surgeons. Editorial comment The article presents work to try to validate two scales for assessing the quality of operating condi- tions during laparoscopic abdominal surgery: one was a 5-point categorical scale, and the other was a 10-point numerical scale. Both scales show a good intra-rater reliability, while the inter- rater reliability was not as strong. Acta Anaesthesiologica Scandinavica 61 (2017) 1270–1277 ª 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd 1270 ORIGINAL ARTICLE An international journal of anaesthesiology, intensive care, pain, and critical emergency medicine