Biomathematical Modeling Predicts Fatigue Risk in General Surgery Residents

Schwartz, Lindsay P.; Devine, Jaime K; Hursh, Steven R.; Mosher, E; Schumacher, Sarah M.; Boyle, Lisa; Davis, Jonathan E.; Smith, Mark S.; Fitzgibbons, Shimae

doi:10.1016/j.jsurg.2021.04.007

Cited by 9 publications

(2 citation statements)

References 25 publications

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“…For reference, Effectiveness scores below 77 indicate PVT performance comparable to an individual with equivalent to 18.5 h of continued wakefulness for a fully rested person or a blood alcohol concentration (BAC) of 0.05 g/dL [31,32]. The ability of AutoSleep to predict average sleep behavior (i.e., sleep timing and duration) as a function of work schedules, time of day, and sleep propensity has been successfully evaluated in shift-working operational populations [30,33,34]. AutoSleep predicts sleep as a function of available time outside of work events as well as time of day.…”

Section: Safte-fast Biomathematical Modeling Softwarementioning

confidence: 99%

Potential Effects of Permanent Daylight Savings Time on Daylight Exposure and Risk during Commute Times across United States Cities in 2023–2024 Using a Biomathematical Model of Fatigue

Devine,

Choynowski,

Hursh

2023

Safety

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Background: Permanent Daylight Savings Time (DST) may improve road safety by providing more daylight in the evening but could merely shift risk to morning commutes or increase risk due to fatigue and circadian misalignment. Methods: To identify how potential daylight exposure and fatigue risk could differ between permanent DST versus permanent Standard Time (ST) or current time arrangements (CTA), generic work and school schedules in five United States cities were modeled in SAFTE-FAST biomathematical modeling software. Commute data were categorized by morning (0700–0900) and evening (1600–1800) rush hours. Results: Percent darkness was greater under DST compared with ST for the total waking day (t = 2.59, p = 0.03) and sleep periods (t = 2.46, p = 0.045). Waketimes occurred before sunrise 63 ± 41% percent of the time under DST compared with CTA (42 ± 37%) or ST (33 ± 38%; F(2,74) = 76.37; p < 0.001). Percent darkness was greater during morning (16 ± 31%) and lower during evening rush hour (0 ± 0%) in DST compared with either CTA (morning: 7 ± 23%; evening: 7 ± 14%) or ST (morning: 7 ± 23%; evening: 7 ± 15%). Discussion: Morning rush hour overlaps with students’ commutes and shift workers’ reverse commutes, which may increase traffic congestion and risk compared with evening rush hour. Switching to permanent DST may be more disruptive than either switching to ST or keeping CTA without noticeable benefit to fatigue or potential daylight exposure.

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Section: Safte-fast Biomathematical Modeling Softwarementioning

confidence: 99%

Potential Effects of Permanent Daylight Savings Time on Daylight Exposure and Risk during Commute Times across United States Cities in 2023–2024 Using a Biomathematical Model of Fatigue

Devine,

Choynowski,

Hursh

2023

Safety

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“…39 A recent line of research by our group has focused on modifying a biomathematical model of fatigue based on residents' own sleep patterns with the intent to create schedule mitigations which are tailored to the needs of the medical resident. These articles by Schwartz et al 40,41 and Devine et al 42 demonstrate the utility of fatigue modeling to identify areas of fatigue risk and evaluate how schedule changes could impact fatigue and performance. Devine et al, characterized the trends and patterns in medical resident sleep using actigraph-collected sleep data over two months.…”

Section: Modeling For Graduate Medical Educationmentioning

confidence: 99%

Addressing fatigue in medical residents with biomathematical fatigue modeling

Schwartz

Devine

Hursh

et al. 2021

Journal of Occupational Health

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Fatigue in resident physicians has been identified as a factor that contributes to burnout and a decline in overall wellbeing. Fatigue risk exists because of poor sleep habits and demanding work schedules that have only increased due to the COVID‐19 pandemic. At this time, it is important not to lose sight of how fatigue can impact residents and how fatigue risk can be mitigated. While fatigue mitigation is currently addressed by duty hour restrictions and education about fatigue, Fatigue Risk Management Systems (FRMSs) offer a more comprehensive strategy for addressing these issues. An important component of FRMS in other shiftwork industries, such as aviation and trucking, is the use of biomathematical models to prospectively identify fatigue risk in work schedules. Such an approach incorporates decades of knowledge of sleep and circadian rhythm research into shift schedules, taking into account not just duty hour restrictions but the temporal placement of work schedules. Recent research has shown that biomathematical models of fatigue can be adapted to a resident physician population and can help address fatigue risk. Such models do not require subject matter experts and can be applied in graduate medical education program shift scheduling. It is important for graduate medical education program providers to consider these alternative methods of fatigue mitigation. These tools can help reduce fatigue risk and may improve wellness as they allow for a more precise fatigue management strategy without reducing overall work hours.

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