Endoscopy 2020; 52(S 01): S243
DOI: 10.1055/s-0040-1704759
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SALIVA STRESS BIOMARKERS CAN RELIABLY ESTIMATE ENDOSCOPY NOVICES’ PERFORMANCE IN A HIGH-END SIMULATOR

N Boyanov
1   Medical University of Plovdiv, Medical Simulation Training Center, Plovdiv, Bulgaria
,
K Georgiou
2   Medical School, National and Kapodistrian University of Athens, 1st Department of Propaedeutic Surgery, Hippokration General Hospital of Athens, Athens, Greece
,
T Deneva
3   Medical University of Plovdiv, Department of Clinical Laboratory, Plovdiv, Bulgaria
4   University Hospital St. George, Central Clinical Laboratory, Plovdiv, Bulgaria
,
K Toutouzas
2   Medical School, National and Kapodistrian University of Athens, 1st Department of Propaedeutic Surgery, Hippokration General Hospital of Athens, Athens, Greece
,
N Oussi
5   Karolinska Institutet, Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm, Sweden
6   Uppsala University, Centre for Clinical Research Sörmland, Uppsala, Sweden
,
L Enochsson
7   Umeå University, Division of Surgery, Department of Surgical and Perioperative Sciences, Umeå, Sweden
,
B Marinov
1   Medical University of Plovdiv, Medical Simulation Training Center, Plovdiv, Bulgaria
8   Medical University of Plovdiv, Pathophysiology Department, Plovdiv, Bulgaria
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Publikationsverlauf

Publikationsdatum:
23. April 2020 (online)

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    Aims The absence of a reliable detection method makes estimating endoscopists’ mental stress difficult to quantify. Although several non-invasive stress measuring methods have been proposed, most studies have used only one or two stress estimation parameters and produced conflicting results. This study concomitantly measures the responses of all previously reported non-invasive stress indices and compares them to the video score (VS) achieved by novice endoscopists in a reproducibly stressful simulation environment.

    Tab. 1

    Mean ± SD and Range of each variable, their Pearson correlation coefficient (r) with VS and their corrected AICc value.

    Variable

    Mean ± SD

    Range (min, max)

    r*

    AICc

    EDAdiff

    795 ± 379

    (275, 1532)

    −0.663

    107.69

    IBIdiff

    1.74 ± 8.88

    (−12.5, 14)

    0.634

    109.49

    HRdiff

    −1.54 ± 8.67

    (−15, 13)

    −0.624

    109.07

    sAAdiff

    251 ± 124

    (21, 445)

    −0.605

    110.31

    Methods 25 male novice trainees were enrolled. After an orientation phase, they wore a wrist device that measures heart rate (HR), interbeat interval (IBI) duration, and electrodermal activity (EDA). A saliva specimen was collected for cortisol (sC), alpha-amylase (sAA), and secretory immunoglobulin A (sIgA) measurements (baseline phase, BL). Then the simulation exercise phase (E) started, with the subjects trained on a basic colonoscopy module (GI-Bronch Mentor). Immediately after, another saliva sample was collected. The whole experiment was videotaped. VS was calculated. The percentage (E-BL)diff of each of the six parameters was calculated and compared with VS using Pearson’s correlation coefficient as well as Akaike Information Criterion (AICc) ([Table 1]).

    Results EDAdiff showed the best correlation with VS, followed by IBIdiff and HRdiff. Among the saliva biomarkers, sAAdiff showed the best correlation in comparison to sIgAdiff and sCdiff.

    Conclusions In our simulation setting, sympathetic ANS stress parameters (EDA, IBI, HR, sAA) could best describe the novice trainees’ performance, but sC and IgA could not.


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