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Boonipat T, Sanchez Figueroa NG, Huang T, Martinez-Jorge J. The impact of chest contouring aesthetics outcomes: a pilot eye tracking study. Case Reports Plast Surg Hand Surg 2023; 11:2287027. [PMID: 38179208 PMCID: PMC10763852 DOI: 10.1080/23320885.2023.2287027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/13/2023] [Indexed: 01/06/2024]
Abstract
Eye-tracking technology was used to assess aesthetic surgical outcomes in transgender and gender diverse patients who are assigned female at birth and who seek gender affirming chest surgery. Post-surgery, observers focused more on scars than on the nipple-areolar complex. Ratings for similarity to cis-male chests significantly increased. This series highlights the objective evaluation of visual perception and masculinity assessments using eye-tracking.
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Affiliation(s)
- Thanapoom Boonipat
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Tony Huang
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA
| | - Jorys Martinez-Jorge
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA
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2
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Pietruski P. Commentary on: The Impact of Breast Symmetry on Eye Movement and Gaze Pattern: An Eye-Tracking Investigation. Aesthet Surg J 2021; 41:NP1519-NP1520. [PMID: 34351384 DOI: 10.1093/asj/sjab309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Piotr Pietruski
- Centre of Postgraduate Medical Education, Gruca Teaching Hospital, Otwock, Poland
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3
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Assessing abdominoplasty aesthetics in women with eye-tracking technology—do patients see things differently? EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-020-01771-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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4
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Li Y, Cao H, Allen CM, Wang X, Erdelez S, Shyu CR. Computational modeling of human reasoning processes for interpretable visual knowledge: a case study with radiographers. Sci Rep 2020; 10:21620. [PMID: 33303770 PMCID: PMC7730148 DOI: 10.1038/s41598-020-77550-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 11/10/2020] [Indexed: 11/18/2022] Open
Abstract
Visual reasoning is critical in many complex visual tasks in medicine such as radiology or pathology. It is challenging to explicitly explain reasoning processes due to the dynamic nature of real-time human cognition. A deeper understanding of such reasoning processes is necessary for improving diagnostic accuracy and computational tools. Most computational analysis methods for visual attention utilize black-box algorithms which lack explainability and are therefore limited in understanding the visual reasoning processes. In this paper, we propose a computational method to quantify and dissect visual reasoning. The method characterizes spatial and temporal features and identifies common and contrast visual reasoning patterns to extract significant gaze activities. The visual reasoning patterns are explainable and can be compared among different groups to discover strategy differences. Experiments with radiographers of varied levels of expertise on 10 levels of visual tasks were conducted. Our empirical observations show that the method can capture the temporal and spatial features of human visual attention and distinguish expertise level. The extracted patterns are further examined and interpreted to showcase key differences between expertise levels in the visual reasoning processes. By revealing task-related reasoning processes, this method demonstrates potential for explaining human visual understanding.
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Affiliation(s)
- Yu Li
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, 65211, USA
| | - Hongfei Cao
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, 65211, USA
| | - Carla M Allen
- Department of Clinical and Diagnostic Science, University of Missouri, Columbia, MO, 65211, USA
| | - Xin Wang
- Department of Information Science, University of Northern Texas, Denton, TX, 76203, USA
| | - Sanda Erdelez
- School of Library and Information Science, Simmons University, Boston, MA, 02115, USA
| | - Chi-Ren Shyu
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, 65211, USA.
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO, 65211, USA.
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Asaad M, Dey JK, Al-Mouakeh A, Manjouna MB, Nashed MA, Rajesh A, Boonipat T, Bite U. Eye-Tracking Technology in Plastic and Reconstructive Surgery: A Systematic Review. Aesthet Surg J 2020; 40:1022-1034. [PMID: 32010929 DOI: 10.1093/asj/sjz328] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The use of eye-tracking technology in plastic surgery has gained popularity over the past decade due to its ability to assess observers' visual preferences in an objective manner. OBJECTIVES The goal of this study was to provide a comprehensive review of eye-tracking studies in plastic and reconstructive surgery, which can aid in the design and conduct of high-quality eye-tracking studies. METHODS Through application of Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines, a comprehensive search of articles published on eye-tracking across several databases was conducted from January 1946 to January 2019. Inclusion criteria included studies evaluating the use of eye-tracking technology in the field of plastic and reconstructive surgery. The resulting publications were screened by 2 independent reviewers. RESULTS A total of 595 articles were identified, 23 of which met our inclusion criteria. The most common application of eye-tracking was to assess individuals with cleft lip/palate (9 studies). All 19 studies that evaluated fixation patterns among conditions vs controls reported significant differences between the 2 groups. Five out of 7 studies assessing visual data between preoperative and postoperative patients identified significant differences between the preoperative and postoperative groups, whereas 2 studies did not. Nine studies examined the relation between severity indices, attractiveness scores, or personality ratings and gaze patterns. Correlation was found in 7 out of the 9 studies. CONCLUSIONS This systematic review demonstrates the utility of eye-tracking technology as a quantifiable objective assessment and emerging research tool for evaluating outcomes in several domains of plastic and reconstructive surgery.
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Affiliation(s)
- Malke Asaad
- Division of Plastic Surgery, Mayo Clinic, Rochester, MN
| | - Jacob K Dey
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN
| | | | | | | | | | | | - Uldis Bite
- Division of Plastic Surgery, Mayo Clinic, Rochester, MN
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6
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Cai L, Nazerali R, Lee GK. Commentary on: The Impact of Mastectomy on Women's Visual Perception of Breast Aesthetics and Symmetry: A Pilot Eye-Tracking Study. Aesthet Surg J 2020; 40:862-863. [PMID: 31886480 DOI: 10.1093/asj/sjz332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Lawrence Cai
- Division of Plastic and Reconstructive Surgery, Stanford University, Stanford, CA
| | - Rahim Nazerali
- Division of Plastic and Reconstructive Surgery, Stanford University, Stanford, CA
| | - Gordon K Lee
- Division of Plastic and Reconstructive Surgery, Stanford University, Stanford, CA
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Pietruski P, Noszczyk B, Paskal AM, Paskal W, Paluch Ł, Jaworowski J. The Impact of Mastectomy on Women's Visual Perception of Breast Aesthetics and Symmetry: A Pilot Eye-Tracking Study. Aesthet Surg J 2020; 40:850-861. [PMID: 31562524 DOI: 10.1093/asj/sjz252] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Little is known about breast cancer survivors' perception of breast attractiveness. A better understanding of this subjective concept could contribute to the improvement of patient-reported outcomes after reconstructive surgeries and facilitate the development of new methods for assessing breast reconstruction outcomes. OBJECTIVES The aim of this eye-tracking (ET)-based study was to verify whether mastectomy altered women's visual perception of breast aesthetics and symmetry. METHODS A group of 30 women after unilateral mastectomy and 30 healthy controls evaluated the aesthetics and symmetry of various types of female breasts displayed as highly standardized digital images. Gaze patterns of women from the study groups were recorded using an ET system and subjected to a comparative analysis. RESULTS Regardless of the study group, the longest fixation duration and the highest fixation number were found in the nipple-areola complex. This area was also the most common region of the initial fixation. Several significant between-group differences were identified; the gaze patterns of women after mastectomy were generally characterized by longer fixation times for the inframammary fold, lower pole, and upper half of the breast. CONCLUSIONS Mastectomy might affect women's visual perception patterns during the evaluation of breast aesthetics and symmetry. ET data might improve our understanding of breast attractiveness and constitute the basis for a new reliable method for the evaluation of outcomes of reconstructive breast surgeries.
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Affiliation(s)
- Piotr Pietruski
- Department of Plastic and Reconstructive Surgery, Medical Centre of Postgraduate Education, Prof. W. Orlowski Memorial Hospital, Warsaw, Poland
| | - Bartłomiej Noszczyk
- Department of Plastic and Reconstructive Surgery, Medical Centre of Postgraduate Education, Prof. W. Orlowski Memorial Hospital, Warsaw, Poland
| | - Adriana M Paskal
- Department of Research Methodology, Laboratory of Center for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Wiktor Paskal
- Department of Research Methodology, Laboratory of Center for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Paluch
- Department of Radiology, Medical Centre of Postgraduate Education, Gruca Orthopaedic and Trauma Teaching Hospital, Otwock, Poland
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Pressler MP, Geisler EL, Hallac RR, Seaward JR, Kane AA. The Use of Eye Tracking to Discern the Threshold at Which Metopic Orbitofrontal Deformity Attracts Attention. Cleft Palate Craniofac J 2020; 57:1392-1401. [PMID: 32489115 DOI: 10.1177/1055665620926014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Surgical treatment for trigonocephaly aims to eliminate a stigmatizing deformity, yet the severity that captures unwanted attention is unknown. Surgeons intervene at different points of severity, eliciting controversy. This study used eye tracking to investigate when deformity is perceived. MATERIAL AND METHODS Three-dimensional photogrammetric images of a normal child and a child with trigonocephaly were mathematically deformed, in 10% increments, to create a spectrum of 11 images. These images were shown to participants using an eye tracker. Participants' gaze patterns were analyzed, and participants were asked if each image looked "normal" or "abnormal." RESULTS Sixty-six graduate students were recruited. Average dwell time toward pathologic areas of interest (AOIs) increased proportionally, from 0.77 ± 0.33 seconds at 0% deformity to 1.08 ± 0.75 seconds at 100% deformity (P < .0001). A majority of participants did not agree an image looked "abnormal" until 90% deformity from any angle. CONCLUSION Eye tracking can be used as a proxy for attention threshold toward orbitofrontal deformity. The amount of attention toward orbitofrontal AOIs increased proportionally with severity. Participants did not generally agree there was "abnormality" until deformity was severe. This study supports the assertion that surgical intervention may be best reserved for more severe deformity.
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Affiliation(s)
- Mark P Pressler
- Department of Plastic Surgery, 12334UT Southwestern, Dallas, TX, USA.,Analytical Imaging and Modeling Center, Children's Medical Center, Dallas, TX, USA
| | - Emily L Geisler
- Department of Plastic Surgery, 12334UT Southwestern, Dallas, TX, USA.,Analytical Imaging and Modeling Center, Children's Medical Center, Dallas, TX, USA
| | - Rami R Hallac
- Department of Plastic Surgery, 12334UT Southwestern, Dallas, TX, USA.,Analytical Imaging and Modeling Center, Children's Medical Center, Dallas, TX, USA
| | - James R Seaward
- Department of Plastic Surgery, 12334UT Southwestern, Dallas, TX, USA.,Analytical Imaging and Modeling Center, Children's Medical Center, Dallas, TX, USA
| | - Alex A Kane
- Department of Plastic Surgery, 12334UT Southwestern, Dallas, TX, USA.,Analytical Imaging and Modeling Center, Children's Medical Center, Dallas, TX, USA
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Analysis of the Visual Perception of Female Breast Aesthetics and Symmetry. Plast Reconstr Surg 2019; 144:1257-1266. [DOI: 10.1097/prs.0000000000006292] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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John KK, Jensen JD, King AJ, Pokharel M, Grossman D. Emerging applications of eye-tracking technology in dermatology. J Dermatol Sci 2018; 91:S0923-1811(18)30156-7. [PMID: 29655589 PMCID: PMC6173990 DOI: 10.1016/j.jdermsci.2018.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/01/2018] [Accepted: 04/03/2018] [Indexed: 10/17/2022]
Abstract
Eye-tracking technology has been used within a multitude of disciplines to provide data linking eye movements to visual processing of various stimuli (i.e., x-rays, situational positioning, printed information, and warnings). Despite the benefits provided by eye-tracking in allowing for the identification and quantification of visual attention, the discipline of dermatology has yet to see broad application of the technology. Notwithstanding dermatologists' heavy reliance upon visual patterns and cues to discriminate between benign and atypical nevi, literature that applies eye-tracking to the study of dermatology is sparse; and literature specific to patient-initiated behaviors, such as skin self-examination (SSE), is largely non-existent. The current article provides a review of eye-tracking research in various medical fields, culminating in a discussion of current applications and advantages of eye-tracking for dermatology research.
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Affiliation(s)
- Kevin K John
- School of Communication, Brigham Young University, United States.
| | - Jakob D Jensen
- Department of Communication, University of Utah, United States; Cancer Control & Population Science Program, Huntsman Cancer Institute, United States
| | - Andy J King
- Department of Public Relations, Texas Tech University, United States
| | | | - Douglas Grossman
- Departments of Dermatology and Oncological Sciences, University of Utah, United States; Huntsman Cancer Institute, University of Utah, United States
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Where Do We Look? Assessing Gaze Patterns in Breast Reconstructive Surgery with Eye-Tracking Technology. Plast Reconstr Surg 2018; 141:331e-340e. [DOI: 10.1097/prs.0000000000004106] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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