Statistical Models in the field of Female Pelvic Medicine and Reconstructive Surgery. With the advancement of statistical learning techniques and training in Data Science, Dr. Jelovsek has devoted effort to improving the accuracy of the informed consent process between patients and surgeons. Rather than provide average estimates of risk based on data from surgical trials (when they exist), statistical models allow predictions to be tailored for low and high-risk patients with increased degree of accuracy. He believes use of these tools allows providers to better triage our recommendations and improve patient satisfaction by better balancing risk and benefits. These tools are programmed on publicly available websites in the Female Pelvic Medicine and Pregnancy section at http://www.riskcalc.org and receive many hits. Supporting manuscripts include:
Jelovsek JE, Chagin K, Gyhagen M, Hagen S, Wilson D, Kattan MW, Elders A, Barber MD, Areskoug B, MacArthur C, Milsom I. Predicting risk of pelvic floor disorders 12 and 20 years after delivery. Am J Obstet Gynecol. 2017 Oct 19. PMID:29056536
Moulton LJ, Eric Jelovsek J, Lachiewicz M, Chagin K, Goje O. A model to predict risk of postpartum infection after Caesarean delivery. J Matern Fetal Neonatal Med. 2017 Jul 11:1-9. PMID:28629241
Stanhiser J, Chagin K, Jelovsek JE. A model to predict risk of blood transfusion after gynecologic surgery. Am J Obstet Gynecol. 2017 Jan 16. PMID: 28104403
Jelovsek JE, Hill AJ, Chagin KM, Kattan MW, Barber MD. Predicting Risk of Urinary Incontinence and Adverse Events After Midurethral Sling Surgery in Women. Obstet Gynecol. 2016 Feb;127(2):330-40. PubMed PMID: 26942362
Jelovsek JE, Chagin K, Brubaker L, et al. PFDN A model for predicting the risk of de novo stress urinary incontinence in women undergoing pelvic organ prolapse surgery. Obstet Gynecol. 2014 Feb;123(2 Pt 1):279-87. PubMed PMID: 24402598; PubMed Central PMCID: PMC3906626.
Jelovsek JE, Piccorelli A, Barber MD, Tunitsky-Bitton E, Kattan MW Prediction models for postpartum urinary and fecal incontinence in primiparous women. Female Pelvic Med Reconstr Surg. 2013 Mar-Apr;19(2):110-8. PubMed PMID: 23442509.
Surgical Trials in Female Pelvic Medicine and Reconstructive Surgery. Surgical trials, especially those using different surgical approaches, are difficult to accomplish due to training of the surgeon and surgeon bias. He believes these studies remain critical to advancing the surgical management of conditions in FPMRS. A few citations are listed:
Jelovsek JE, Barber MD, Brubaker L, Norton P, Gantz M, Richter HE, Weidner A, Menefee S, Schaffer J, Pugh N, Meikle S. Effect of Uterosacral Ligament Suspension vs Sacrospinous Ligament Fixation With or Without Perioperative Behavioral Therapy for Pelvic Organ Vaginal Prolapse on Surgical Outcomes and Prolapse Symptoms at 5 Years in the OPTIMAL Randomized Clinical Trial. JAMA. 2018 Apr 17;319(15):1554-1565. PMID: 29677302
Paraiso MF, Ridgeway B, Park AJ, Jelovsek JE, Barber MD, et al. A randomized trial comparing conventional and robotically assisted total laparoscopic hysterectomy. Am J Obstet Gynecol. 2013 May;208(5):368.e1-7. PubMed PMID: 23395927.
Barber MD, Weidner AC, Sokol AI, Amundsen CL, Jelovsek JE, et al. Single-incision mini-sling compared with tension-free vaginal tape for the treatment of stress urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2012 Feb;119(2 Pt 1):328-37. PubMed PMID: 22270285.
Paraiso MF, Jelovsek JE, Frick A, Chen CC, Barber MD. Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial. Obstet Gynecol. 2011 Nov;118(5):1005-13. PubMed PMID: 21979458.
Jelovsek JE, Barber MD, Karram MM, Walters MD, Paraiso MF. Randomised trial of laparoscopic Burch colposuspension versus tension-free vaginal tape: long-term follow up. BJOG. 2008 Jan;115(2):219-25; discussion 225. PubMed PMID: 18081602.
Surgical Education and Development and Validation of Surgical Training Models. Surgical education is a cornerstone to being an academic surgeon. However, a good surgical teacher is not always using best evidence in education as they may in clinical care. Dr. Jelovsek feels the responsibility to study best educational methods in the field for teaching and assessment just as much as one would for taking care of patients. Additionally, he believes it is an ethical responsibility of surgeons to use non-patient models to learn when they are available and useful to avoid early learning on patients. His dedication to creating a variety of surgical simulators in our field has resulted. A few examples are listed:
Wohlrab K, Jelovsek JE, Myers D. Incorporating simulation into gynecologic surgical training. American Journal of Obstetrics and Gynecology. 2017; 217(5):522-526.PMID:28511894
Kow N, Walters MD, Karram MM, Sarsotti CJ, Jelovsek JE. Assessing intraoperative judgment using script concordance testing through the gynecology continuum of practice. Med Teach. 2014 Aug;36(8):724-9. PubMed PMID: 24819908.
Tunitsky-Bitton E, King CR, Ridgeway B, Barber MD, Lee T, Jelovsek JE. Development and validation of a laparoscopic sacrocolpopexy simulation model for surgical training. J Minim Invasive Gynecol. 2014 Jul-Aug;21(4):612-8. PubMed PMID: 24462591.
Tunitsky E, Murphy A, Barber MD, Simmons M, Jelovsek JE. Development and validation of a ureteral anastomosis simulation model for surgical training. Female Pelvic Med Reconstr Surg. 2013 Nov-Dec;19(6):346-51. PubMed PMID: 24165448.
Jelovsek JE, Kow N, Diwadkar GB. Tools for the direct observation and assessment of psychomotor skills in medical trainees: a systematic review. Med Educ. 2013 Jul;47(7):650-73. PubMed PMID: 23746155.
Epidemiology of Pelvic Floor Disorders. Understanding cause and effect in the field of Female Pelvic Medicine has provided the foundation for almost all of his clinical research questions. His experience has included a variety of publications in various areas of epidemiology of pelvic floor disorders including quality of life, statistical methods of using quality of life instruments and poorly understood disorders such as bowel disorders related to the pelvic floor. He believes that understanding these complex relationships allow treating surgeons to appropriately counsel patients so they may select the best treatment for them to improve their quality of life.
Jelovsek JE, Chen Z, Markland AD, Brubaker L, Dyer KY, et al. Minimum important differences for scales assessing symptom severity and quality of life in patients with fecal incontinence. Female Pelvic Med Reconstr Surg. 2014 Nov-Dec;20(6):342-8. PubMed PMID: 25185630; PubMed Central PMCID: PMC4213305.
Jelovsek JE, Walters MD, Paraiso MF, Barber MD. Functional bowel disorders and pelvic organ prolapse: a case-control study. Female Pelvic Med Reconstr Surg. 2010 Jul;16(4):209-14. PubMed PMID: 22453343.
Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet. 2007 Mar 24;369(9566):1027-38. PubMed PMID: 17382829.
Jelovsek JE, Barber MD. Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol. 2006 May;194(5):1455-61. PubMed PMID: 16647928.