JMIR Publications

ABSTRACT

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 technology has demonstrated this capability in other domains. However, the use of low-burden wearable biosensors to study training and clinical practice among Emergency Physicians remains untested.

Objective:

This pilot study aims to determine the feasibility of recording on-shift photoplethysmographic data, to calculate standard pulse rate variability metrics from the acquired dataset, and to examine patterns in these variables over the course of an academic year. The ultimate goal of these aims is to provide the first characterization of patterns in pulse rate variability among Emergency Physicians, in addition to generating an assessment of the feasibility and suitability of such methodology for use on a larger scale to study physician burnout.

Methods:

Twenty-one Emergency Physicians wore photoplethysmography biosensors during clinical work in the Emergency Department. Recordings were collected during the first quarter of the academic year, then again during the fourth quarter of the same year for comparison. Standard heart rate and pulse rate variability metrics from these two time points were calculated and entered into Student’s T-tests.

Results:

More than four hundred hours of data entered these analyses. Intepretable data was captured during 8.54% of the total recording time overall. In the fourth quarter of the academic year compared to the first quarter, there was no significant difference in median heart rate (75.8 vs. 76.8, p=0.57), mean R-R interval (0.81 vs. 0.80, p=0.32), standard deviation of R-R interval (0.11 vs. 0.11, p=0.93), root-mean-square of successive difference of R-R interval (0.81 vs. 0.80, p=0.96), low-frequency power (3.5 x103 vs. 3.4 x103, p=0.79), high-frequency power (8.5 x103 vs. 8.3 x103, p=0.91), or low-frequency to high-frequency ratio (0.42 vs. .41, p=0.43), respectively. Power estimates for each of these tests exceeded 0.90. A secondary analysis of the resident-only subgroup similarly showed no significant differences over time, despite power estimates greater than 0.80.

Conclusions:

While the use of photoplethysmography biosensors to record real-time physiological data from emergency physicians while provding 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 heart rate or pulse rate variability analyses were found at the end of the year compared to the beginning. While these metrics may offer useful applications to other domains, it may currently have limited utility in the contexts of physician training and wellness.