A quantitative approach to assess similarity between dives under the Buhlmann decompression algorithm constraints

Undersea and high-altitude operations regularly put operators at risk for decompression sickness (DCS), which is attributed to bubble formation and growth during decompression. DCS mitigation strategies are validated with empirical testing, often conducted in hyperbaric chambers, which provide precise control of the pressure-time profile. A degree of variability for study outcome is anticipated in both decompression sickness (DCS) and venous gas emboli (VGE) endpoints. Experimentation in a chamber offers precision, but is not always practical or operationally relevant, leading researchers to use open water for the dive exposure. Dive profile consistency may vary by diver skill level and environmental conditions, potentially introducing dive profile deviations, which may be a factor of individual variability. There does not exist a quantitative framework for evaluating dive profile consistency and quantifying deviations in open water studies. In this work, we evaluate existing dive profile metrics and propose a workflow to estimate dive profile deviations using the Buhlmann dissolved gas phase model. The dive profile metrics included depth and time-based calculations, as well as surface gradient factor, degree-of-conservatism and the root mean square error of the Buhlmann tissue compartments. We developed a set of simulated dive profiles and obtained a set of 40 open water dives previously collected by certified divers, both of which were used to evaluate performance of the dive profile metrics. Depth and time-based metrics offered sensitivity to varying depths and time durations of the dive profiles, respectively. For the field dives, we found the Buhlmann root mean square error metric performed best at identifying the deviation profile, followed by pressure root time. These evaluations demonstrate the utility and limitations of previously published dive profile metrics and emphasize the importance of accounting for dive profile consistency in open water decompression trials.