Accepted for/Published in: JMIR Human Factors
Date Submitted: Jul 16, 2023
Date Accepted: Sep 23, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Feasibility and Reliability of Upper Arm-Worn Apple Watch Heart Rate Monitoring for Surgeons during Surgery: pilot study
ABSTRACT
Background:
The well-being of physicians, particularly surgeons, has been largely ignored in the medical field despite their high levels of stress. Wrist-worn heart rate monitors have become more prevalent, but cannot be worn during surgery.
Objective:
This study aims to examine the feasibility of using an Apple Watch worn on the upper arm of a surgeon to collect heart rate data during surgery.
Methods:
This study used two identical Apple Watch Series 8 devices to monitor the heart rate of surgeons during robotic-assisted surgery. Heart rate data was collected from the wrist-worn and the upper arm-worn, and statistical analysis included calculating the mean difference and standard deviation of difference between the two devices, constructing Bland-Altman plots, assessing accuracy based on mean absolute error (MAE) and mean absolute percentage error (MAPE), and calculating intraclass correlation coefficient. Demographic information and surgical data were also collected.
Results:
The MAE for the whole group and for subjects A, B, C and D were 3.63, 3.58, 2.70, 3.93 and 4.28, respectively, and the MAPE were 3.58%, 3.34%, 2.42%, 4.58% and 4.00%, respectively. Bland-Altman plots and scatter plots showed no systematic error when comparing the heart rate measurements obtained from the upper arm-worn and the wrist-worn Apple Watches. The ICC for subjects A, B, C and D were 0.559, 0.651, 0.508, 0.563 (P<.001).Following the previously mentioned limits, this can be interpreted as moderate reliability.
Conclusions:
This study suggests that the upper arm-worn is a viable alternative site for monitoring heart rate during surgery using an Apple Watch. The agreement and reliability between the measurements obtained from the upper arm-worn and the wrist-worn were good, with no systematic error and a high level of accuracy. The findings of this study have important implications for improving data collection and management of the physical and mental demands of surgeons during surgery, where wearing a watch on the wrist is not feasible. Clinical Trial: This study was approved by the Institutional Review Board (IRB) of Gunma Prefectural Cancer Center (IRB number 405-04030).
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