Effect of consumer-grade wearable device data on clinician decision making during post-discharge telephone calls after pediatric surgery

Samuel C. Linton, Christopher De Boer, Yao Tian, Amin Alayleh, Megan E. Bouchard, Angie Figueroa, Soyang Kwon, Jane Louise Holl, Hassan MK Ghomrawi, Fizan Abdullah*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: During post-discharge telephone calls after pediatric surgery, clinicians must rely on parents/caregivers’ assessment of symptoms, which can be inaccurate and often lead to unnecessary emergency department (ED) visits. Physiology (heart rate and physical activity) data from consumer-grade wearables, e.g., Fitbit™, may inform clinical decision making, yet there has been little study of clinician interpretation of this data. This study assessed whether wearable data availability, during simulated telephone calls about postoperative, post-discharge pediatric patients, affects clinician decision making. Methods: Three simulated telephone call scenarios were presented to a diverse group of pediatric surgery clinicians. The scenarios were based on actual postoperative patients (scenarios 1 and 3 have worrisome symptoms and scenario 2 has non-worrisome symptoms) who had worn a Fitbit™ postoperatively. Each scenario was presented to clinicians (1) without any wearable data; (2) with “concerning” wearable data; and (3) with “reassuring” wearable data. Clinicians rated their likelihood, on a scale of 1–10, of recommending an emergency department (ED) visit for the three instances of each scenario, 10 being definitely ED. Results: Twenty-four (24) clinicians participated in the study. When presented with “reassuring” wearable data, clinicians’ likelihood of recommending an ED visit decreased from a median score of 6 to 1 (p < 0.001) for scenario 1 and from 9 to 3 (p < 0.001) for scenario 3. When presented with “concerning” wearable data, the median likelihood of recommending an ED visit increased from 1 to 6 (p = 0.003) for scenario 2. Conclusion: This study showed that wearable data affect clinicians’ decision making and may be useful in triaging postoperative, post-discharge pediatric patients. Level of evidence: V.

Original languageEnglish (US)
Pages (from-to)137-142
Number of pages6
JournalJournal of pediatric surgery
Volume57
Issue number9
DOIs
StatePublished - Sep 2022

Keywords

  • Clinical decision making
  • Physical activity
  • Postoperative recovery
  • Remote patient monitoring
  • Transition of care
  • Wearable device

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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