title: Performance Evaluation of a Salivary Amylase Biosensor for Stress Assessment in Military Field Research.
abstract: BACKGROUND
  A convenient biosensor for real-time measurement of biomarkers for in-field psychophysiological stress research and military operations is desirable. We evaluated a hand-held device for measuring salivary amylase as a stress marker in medical technicians undergoing combat casualty care training using two different modalities in operating room and field settings.
  
  
  METHODS
  Salivary amylase activity was measured by two biosensor methods: directly sampling saliva with a test strip placed under the tongue or pipetting a fixed volume of precollected saliva onto the test strip, followed by analyzing the sample on the strip using a biosensor. The two methods were compared for their accuracy and sensitivity to detect the stress response using an enzyme assay method as a standard.
  
  
  RESULTS
  The measurements from the under-the-tongue method were not as consistent with those from the standard assay method as the values obtained from the pipetting method. The under-the-tongue method did not detect any significant increase in the amylase activity due to stress in the operating room (P > 0.1), in contrast to the significant increases observed using the pipetting method and assay method with a significance level less than 0.05 and 0.1, respectively. Furthermore, the under-the-tongue method showed no increased amylase activity in the field testing, while both the pipetting method and assay method showed increased amylase activity in the same group (P < 0.1).
  
  
  CONCLUSIONS
  The accuracy and consistency of the biosensors need to be improved when used to directly measure salivary amylase activity under the tongue for stress assessment in military medical training.
authors.affiliation: Defence Research and Development Canada, Toronto Research Centre, Toronto, Ontario, Canada.
authors.forename: Henry T
authors.initials: HT
authors.lastname: Peng
authors.affiliation: Canadian Forces Health Services, Ottawa, Ontario, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Savage
authors.affiliation: Defence Research and Development Canada, Toronto Research Centre, Toronto, Ontario, Canada.
authors.forename: Oshin
authors.initials: O
authors.lastname: Vartanian
authors.affiliation: Canadian Forces Health Services, Ottawa, Ontario, Canada.
authors.forename: Shane
authors.initials: S
authors.lastname: Smith
authors.affiliation: Defence Research and Development Canada, Toronto Research Centre, Toronto, Ontario, Canada.
authors.forename: Shawn G
authors.initials: SG
authors.lastname: Rhind
authors.affiliation: Defence Research and Development Canada, Suffield Research Centre, Medicine Hat, Alberta, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Tenn
authors.affiliation: Defence Research and Development Canada, Suffield Research Centre, Medicine Hat, Alberta, Canada.
authors.forename: Stephen
authors.initials: S
authors.lastname: Bjamason
mesh_terms: D015374:Biosensing Techniques / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel; D012463:Saliva / Q000201:enzymology*; D013315:Stress, Psychological / Q000201:enzymology*; D000516:alpha-Amylases / Q000378:metabolism*
chemical_list: D000516:alpha-Amylases
keywords: biosensor; military medical training; salivary amylase; stress