Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland; Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland.
Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland; STRATUS Centre for Medical Simulation, Brigham & Women's Hospital, Boston, Massachusetts; Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts.
J Surg Res. 2024 Oct;302:222-231. doi: 10.1016/j.jss.2024.07.009. Epub 2024 Aug 5.
Cognitive load (CogL) is increasingly recognized as an important resource underlying operative performance. Current innovations in surgery aim to develop objective performance metrics via physiological monitoring from wearable digital sensors. Surgeons have access to consumer technology that could measure CogL but need guidance regarding device selection and implementation. To realize the benefits of surgical performance improvement these methods must be feasible, incorporating human factors usability and design principles. This paper aims to evaluate the feasibility of using wearable sensors to assess CogL, identify the benefits and challenges of implementing devices, and develop guidance for surgeons planning to implement wearable devices in their research or practice.
We examined the feasibility of wearable sensors from a series of empirical studies that measured aspects of clinical performance relating to CogL. Across four studies, 84 participants and five sensors were involved in the following clinical settings: (i) real intraoperative surgery; (ii) simulated laparoscopic surgery; and (iii) medical team performance outside the hospital.
Wearable devices worn on the wrist and chest were found to be comfortable. After a learning curve, electrodermal activity data were easily and reliably collected. Devices using photoplethysmography to determine heart rate variability were significantly limited by movement artifact. There was variable success with electroencephalography devices regarding connectivity, comfort, and usability.
It is feasible to use wearable sensors across various clinical settings, including surgery. There are some limitations, and their implementation is context and device dependent. To scale sensor use in clinical research, surgeons must embrace human factors principles to optimize wearability, usability, reliability, and data security.
认知负荷（CogL）越来越被认为是手术操作表现的重要资源。当前的手术创新旨在通过可穿戴数字传感器的生理监测来开发客观的操作性能指标。外科医生可以使用消费者技术来测量 CogL，但需要有关设备选择和实施的指导。为了实现手术性能改进的好处，这些方法必须是可行的，同时要结合人体工程学可用性和设计原则。本文旨在评估使用可穿戴传感器评估 CogL 的可行性，确定实施设备的好处和挑战，并为计划在研究或实践中使用可穿戴设备的外科医生提供指导。
我们通过一系列经验研究来检查可穿戴传感器的可行性，这些研究测量了与 CogL 相关的临床性能方面。在四项研究中，84 名参与者和五台传感器涉及以下临床环境：（i）真实的术中手术；（ii）模拟腹腔镜手术；以及（iii）医院外的医疗团队表现。
手腕和胸部佩戴的可穿戴设备被发现舒适。经过学习曲线后，很容易且可靠地收集皮肤电活动数据。使用光体积描记法确定心率变异性的设备受到运动伪影的严重限制。脑电图设备在连接性、舒适性和可用性方面存在不同程度的成功。
在各种临床环境中，包括手术中，使用可穿戴传感器是可行的。存在一些限制，其实施取决于具体情况和设备。为了在临床研究中扩大传感器的使用，外科医生必须采用人体工程学原则，以优化可穿戴性、可用性、可靠性和数据安全性。
