Objective Measurement of Physician Stress in the Emergency Department Using a Wearable Sensor

Abstract

Physician stress, and resultant consequences such as burnout, have become increasingly recognized pervasive problems, particularly within the specialty of Emergency Medicine. Stress is difficult to measure objectively, and research predominantly relies on self-reported measures. The present study aims to characterize digital biomarkers of stress as detected by a wearable sensor among Emergency Medicine physicians. Physiologic data were continuously collected using a wearable sensor during clinical work in the emergency department, and participants were asked to self-identify episodes of stress. Machine learning algorithms were used to classify self-reported episodes of stress. Comparing baseline sensor data to data in the 20-minute period preceding self-reported stress episodes demonstrated the highest prediction accuracy for stress. With further study, detection of stress via wearable sensors could be used to facilitate evidence-based stress research and just-in-time interventions for emergency physicians and other high-stress professionals.

Figure 1:

Empatica E4

Figure 2.

Pre-stress event vs post-stress event confusion matrix

Figure 3.

Pre-stress event vs post-stress event ROC curve

Figure 4.

Baseline vs pre-stress event confusion matrix

Figure 5.

Baseline vs pre-stress event ROC curve

Figure 6.

Baseline vs post-stress event confusion matrix

Figure 7.

Baseline vs post-stress event ROC curve