@Article{info:doi/10.2196/50891,
author="Yamada, Kazunosuke
and Enokida, Yasuaki
and Kato, Ryuji
and Imaizumi, Jun
and Takada, Takahiro
and Ojima, Hitoshi",
title="The Feasibility and Reliability of Upper Arm--Worn Apple Watch Heart Rate Monitoring for Surgeons During Surgery: Observational Study",
journal="JMIR Hum Factors",
year="2023",
month="Nov",
day="1",
volume="10",
pages="e50891",
keywords="Apple Watch; heart rate; surgery; robot",
abstract="Background: Health care professionals, particularly those in surgical settings, face high stress levels, impacting their well-being. Traditional monitoring methods, like using Holter electrocardiogram monitors, are impractical in the operating room, limiting the assessment of physicians' health. Wrist-worn heart rate monitors, like the Apple Watch, offer promise but are restricted in surgeries due to sterility issues. Objective: This study aims to assess the feasibility and accuracy of using an upper arm--worn Apple Watch for heart rate monitoring during robotic-assisted surgeries, comparing its performance with that of a wrist-worn device to establish a reliable alternative monitoring site. Methods: This study used 2 identical Apple Watch Series 8 devices to monitor the heart rate of surgeons during robotic-assisted surgery. Heart rate data were collected from the wrist-worn and the upper arm--worn devices. Statistical analyses included calculating the mean difference and SD of difference between the 2 devices, constructing Bland-Altman plots, assessing accuracy based on mean absolute error and mean absolute percentage error, and calculating the intraclass correlation coefficient. Results: The mean absolute errors for the whole group and for participants A, B, C, and D were 3.63, 3.58, 2.70, 3.93, and 4.28, respectively, and the mean absolute percentage errors 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 intraclass correlation coefficients for participants A, B, C, and D were 0.559, 0.651, 0.508, and 0.563, respectively, with a significance level of P<.001, indicating moderate reliability. Conclusions: The findings of this study suggest that the upper arm 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 devices were good, with no systematic error and a high level of accuracy. These findings have important implications for improving data collection and management of the physical and mental demands of operating room staff during surgery, where wearing a watch on the wrist may not be feasible. ",
issn="2292-9495",
doi="10.2196/50891",
url="https://humanfactors.jmir.org/2023/1/e50891",
url="https://doi.org/10.2196/50891",
url="http://www.ncbi.nlm.nih.gov/pubmed/37910162"
}