ArticleJournal of biomedical informatics2019
Physiological synchronization and entropy as measures of team cognitive load.
Article in Journal of biomedical informatics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Systematic review of neurophysiological assessment techniques and metrics for mental workload evaluation in real-world settings.Frontiers in neuroergonomics · 2025Pooled it
- Assessment methods for surgeons' ergonomics in the operating room: a scoping review.Surgical endoscopy · 2026Article
- A Methodological Framework to Study Change in Team Cognition Under the Dynamical Hypothesis.Topics in cognitive science · 2026Article
- Interdisciplinary Dialogues on Surgical Data Science: Revising Its Benefits for Surgical Stakeholders and Patients.IEEE transactions on medical robotics and bionics · 2026Article
- Understanding quantitative effects of anti-amyloid therapies on tau biomarkers and functional outcome. Insights from a comprehensive mechanistic quantitative systems pharmacology study.Frontiers in pharmacology · 2026Article
- A scoping review of cognitive load assessment tools suitable for clinicians performing REBOA.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- A novel multimodal, intraoperative cognitive workload assessment of cardiac surgery team members.The Journal of thoracic and cardiovascular surgery · 2025Article
- Physiologically informed predictability of a teammate's future actions forecasts team performance.iScience · 2025Article
- Physiological team dynamics explored: physiological synchrony in medical simulation training.Advances in simulation (London, England) · 2025Article
- From Teams to Teamness: Future Directions in the Science of Team Cognition.Human factors · 2024Review
- Review
- An Open-Source, Interoperable Architecture for Generating Real-Time Surgical Team Cognitive Alerts from Heart-Rate Variability Monitoring.Sensors (Basel, Switzerland) · 2023Article
- multiSyncPy: A Python package for assessing multivariate coordination dynamics.Behavior research methods · 2023Article
- Exploring objective measures for assessing team performance in healthcare: an interview study.Frontiers in psychology · 2023Article
- Measuring teamwork for training in healthcare using eye tracking and pose estimation.Frontiers in psychology · 2023Article
- Assessing Team Situational Awareness in the Operating Room via Computer Vision.IEEE Conference on Cognitive and Computational Aspects of Situation Management (CogSIMA) · 2022Article
- Stress and autonomic nerve dysfunction monitoring in perioperative gastric cancer patients using a smart device.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2022Observational
- Better forbearance, lower depression: Evidence based on heart rate variability.Frontiers in psychology · 2022Article
- Sensors for Continuous Monitoring of Surgeon's Cognitive Workload in the Cardiac Operating Room.Sensors (Basel, Switzerland) · 2020Article
- Analysis of Mirrored Psychophysiological Change of Cardiac Surgery Team Members During Open Surgery.Journal of surgical educationArticle
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
The operating room (OR) is a high-risk and complex environment, where multiple specialized professionals work as a team to effectively care for patients in need of surgical interventions. Surgical tasks impose high cognitive demands on OR staff and cognitive overload may have deleterious effects on team performance and patient safety. The aim of the present study was to investigate the feasibility and describe a novel methodological approach to characterize dynamic changes in team cognitive load by measuring synchronization and entropy of heart rate variability parameters during real-life cardiac surgery. Cognitive load was measured by capturing interbeat intervals (IBI) from three team members (surgeon, anesthesiologist and perfusionist) using an unobtrusive wearable heart rate sensor and transmitted in real-time to a smartphone application. Clinical data and operating room audio/video recordings were also collected to provide behavioral and contextual information. We developed symbolic representations of the transient cognitive state of individual team members (Individual Cognitive State - ICS), and overall team (Team Cognitive State - TCS) by comparing IBI data from each team member with themselves and with others. The distribution of TCS symbols during surgery enabled us to display and analyze temporal states and dynamic changes of team cognitive load. Shannon's entropy was calculated to estimate the changing levels of team organization and to detect fluctuations resulting from a variety of cognitive demands and/or specific situations (e.g. medical error, emergency, flow disruptions). An illustrative example from a real cardiac surgery team shows how cognitive load patterns shifted rapidly after an actual near-miss medication event, leading the team to a more organized and synchronized state. The methodological approach described in this study provides a measurement technique for the assessment of team physiological synchronization, which can be applied to many other team-based environments. Future research should gather additional validity evidence to support the proposed methods for team cognitive load measurement.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.