Pulse Rate Variability in Emergency Physicians During Shifts: Pilot Cross-Sectional Study
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Résumé
BACKGROUND: The high prevalence of physician burnout, particularly in emergency medicine, has garnered national attention in recent years. Objective means of measuring stress while at work can facilitate research into stress reduction interventions, and wearable photoplethysmography (PPG) technology has been proposed as a potential solution. However, the use of low-burden wearable biosensors to study training and clinical practice among emergency physicians (EP) remains untested. OBJECTIVE: This pilot study aimed to (1) determine the feasibility of recording on-shift photoplethysmographic data from EP, (2) assess the quality of these data, and (3) calculate standard pulse rate variability (PRV) metrics from the acquired dataset and examine patterns in these variables over the course of an academic year. METHODS: A total of 21 EP wore PPG biosensors on their wrists during clinical work in the emergency department during a 9-hour shift. Recordings were collected during the first quarter of the academic year, then again during the fourth quarter of the same year for comparison. The overall rate of usable data collection per time was computed. Standard pulse rate (PR) and PRV metrics from these two time points were calculated and entered into Student t tests. RESULTS: More than 400 hours of data were entered into these analyses. Interpretable data were captured during 8.54% of the total recording time overall. In the fourth quarter of the academic year compared with the first quarter, there was no significant difference in median PR (75.8 vs 76.8; P=.57), mean R-R interval (0.81 vs 0.80; P=.32), SD of R-R interval (0.11 vs 0.11; P=.93), root mean square of successive difference of R-R interval (0.81 vs 0.80; P=.96), low-frequency power (3.5×103 vs 3.4×103; P=.79), high-frequency power (8.5×103 vs 8.3×103; P=.91), or low-frequency to high-frequency ratio (0.42 vs 0.41; P=.43), respectively. Power estimates for each of these tests exceeded .90. A secondary analysis of the resident-only subgroup similarly showed no significant differences over time, despite power estimates greater than .80. CONCLUSIONS: Although the use of PPG biosensors to record real-time physiological data from EP while providing clinical care seems operationally feasible, this study fails to support the notion that such an approach can efficiently provide reliable estimates of metrics of interest. No significant differences in PR or PRV metrics were found at the end of the year compared with the beginning. Although these methods may offer useful applications to other domains, it may currently have limited utility in the contexts of physician training and wellness.
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle