{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T03:47:50Z","timestamp":1774669670504,"version":"3.50.1"},"reference-count":24,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012912","name":"Imperial College Healthcare Charity","doi-asserted-by":"publisher","award":["167120"],"award-info":[{"award-number":["167120"]}],"id":[{"id":"10.13039\/100012912","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Objective: Quality of intraoperative teamwork may have a direct impact on patient outcomes. Heart rate variability (HRV) synchrony may be useful for objective assessment of team cohesion and good teamwork. The primary aim of this study was to investigate the feasibility of using HRV synchrony in surgical teams. Secondary aims were to investigate the association of HRV synchrony with length of procedure (LOP), complications, number of intraoperative glitches and length of stay (LOS). We also investigated the correlation between HRV synchrony and team familiarity, pre- and intraoperative stress levels (STAI questionnaire), NOTECHS score and experience of team members. Methods: Ear, nose and throat (ENT) and vascular surgeons (consultant and registrar team members) were recruited into the study. Baseline demographics including level of team members\u2019 experience were gathered before each procedure. For each procedure, continuous electrocardiogram (ECG) recording was performed and questionnaires regarding pre- and intraoperative stress levels and non-technical skills (NOTECHS) scores were collected for each team member. An independent observer documented the time of each intraoperative glitch. Statistical analysis was conducted using stepwise multiple linear regression. Results: Four HRV synchrony metrics which may be markers of efficient surgical collaboration were identified from the data: 1. number of HRV synchronies per hour of procedure, 2. number of HRV synchrony trends per hour of procedure, 3. length of HRV synchrony trends per hour of procedure, 4. area under the HRV synchrony trend curve per hour of procedure. LOP was inversely correlated with number of HRV synchrony trends per hour of procedure (p &lt; 0.0001), area under HRV synchrony trend curve per hour of procedure (p = 0.001), length of HRV synchrony trends per hour of procedure (p = 0.002) and number of HRV synchronies per hour of procedure (p &lt; 0.0001). LOP was positively correlated with: FS (p = 0.043; R = 0.358) and intraoperative STAI score of the whole team (p = 0.007; R = 0.493). Conclusions: HRV synchrony metrics within operating teams may be used as an objective marker to quantify surgical teamwork. We have shown that LOP is shorter when the intraoperative surgical teams\u2019 HRV is more synchronised.<\/jats:p>","DOI":"10.3390\/s22228998","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T04:39:59Z","timestamp":1669005599000},"page":"8998","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A Pilot Study of Heart Rate Variability Synchrony as a Marker of Intraoperative Surgical Teamwork and Its Correlation to the Length of Procedure"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5887-8551","authenticated-orcid":false,"given":"Katarzyna","family":"Powezka","sequence":"first","affiliation":[{"name":"Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London W2 1NY, UK"}]},{"given":"Allan","family":"Pettipher","sequence":"additional","affiliation":[{"name":"Department of Electrical and Electronic Engineering, Imperial College London, London SW7 2AZ, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0143-6191","authenticated-orcid":false,"given":"Apit","family":"Hemakom","sequence":"additional","affiliation":[{"name":"Department of Electrical and Electronic Engineering, Imperial College London, London SW7 2AZ, UK"}]},{"given":"Tricia","family":"Adjei","sequence":"additional","affiliation":[{"name":"Department of Electrical and Electronic Engineering, Imperial College London, London SW7 2AZ, UK"}]},{"given":"Pasha","family":"Normahani","sequence":"additional","affiliation":[{"name":"Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London W2 1NY, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8432-3963","authenticated-orcid":false,"given":"Danilo P.","family":"Mandic","sequence":"additional","affiliation":[{"name":"Department of Electrical and Electronic Engineering, Imperial College London, London SW7 2AZ, UK"}]},{"given":"Usman","family":"Jaffer","sequence":"additional","affiliation":[{"name":"Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London W2 1NY, UK"},{"name":"Department of Vascular Surgery, Imperial College Healthcare NHS Trust, London W2 1NY, UK"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.18261\/issn.1892-2686-2016-01-05","article-title":"Respecting as a basic teamwork process in the operating theatre\u2014A qualitative study of theatre Respecting as a basic teamwork process in the operating theatre","volume":"6","author":"Kaldheim","year":"2016","journal-title":"Nord. 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