The most prevalent methodology used in conducting FCEs is “own-design” protocol. The science of work physiology, and in particular the heart rate reserve formula, is an essential factor for time tolerance of work, but is not present in the “own-design” and commercial FCE methods. Across the spectrum of FCE provider protocols, and FCE report methods, there is a varying range of approaches used to determine the full-time work status of the examinee. A scientifically recognized work physiological standardization—the heart rate reserve formula—was utilized for comparative analysis on 151 FCE reports to determine work time tolerance assessment practices. Results: There are two categories of FCE protocols, the “own-design” method and commercial method. Neither of these use the heart rate reserve formula as a quantitative procedure; which identifies lack of professional competence, flawed methodology, and lack of scientifically supported opinions. The professional dictum of evidence-based practice demands that the FCE body of knowledge and providers embrace the science of work physiology as a benchmark. All FCE providers and commercial vendors should be expected to have professional work physiology credentials, discard procedures which are not heart rate reserve methods, and adopt transparent procedures so that there is credibility in the time tolerance opinions in the FCE.
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