1
|
Narasimha S, Obuseh M, Anton NE, Chen H, Chakrabarty R, Stefanidis D, Yu D. Eye tracking and audio sensors to evaluate surgeon's non-technical skills: An empirical study. APPLIED ERGONOMICS 2024; 119:104320. [PMID: 38797012 DOI: 10.1016/j.apergo.2024.104320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/06/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024]
Abstract
Non-Technical Skills (NTS) of medical teams are currently measured using subjective and resource-intensive ratings given by experts. This study explores if objective NTS assessment approaches with eye-tracking and audio sensors can measure teamwork and communication skills in surgery. Eight surgeons participated in a simulated two-phase surgical scenario developed to assess their NTS. Sensor-based audio, eye tracking and video data were collected and analyzed along with rating from the NOTSS scale. Different levels of communication were detected by the sensor data during the two phases of the simulated surgery. Sensor data detected leadership qualities among surgeons based on speech metrics, and eye tracking offered additional evidence about gaze patterns related to NTS. This objective approach to NTS measurement captured differences in communication in greater detail as opposed to a single collective rating obtained using current assessment tools.
Collapse
Affiliation(s)
| | - Marian Obuseh
- School of Industrial Engineering, Purdue University, USA
| | - Nicholas Eric Anton
- School of Industrial Engineering, Purdue University, USA; School of Medicine, Indiana University, USA
| | - Haozhi Chen
- School of Industrial Engineering, Purdue University, USA
| | | | | | - Denny Yu
- School of Industrial Engineering, Purdue University, USA
| |
Collapse
|
2
|
Zhu L, Chen J, Yang H, Zhou X, Gao Q, Loureiro R, Gao S, Zhao H. Wearable Near-Eye Tracking Technologies for Health: A Review. Bioengineering (Basel) 2024; 11:738. [PMID: 39061820 PMCID: PMC11273595 DOI: 10.3390/bioengineering11070738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 07/12/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
With the rapid advancement of computer vision, machine learning, and consumer electronics, eye tracking has emerged as a topic of increasing interest in recent years. It plays a key role across diverse domains including human-computer interaction, virtual reality, and clinical and healthcare applications. Near-eye tracking (NET) has recently been developed to possess encouraging features such as wearability, affordability, and interactivity. These features have drawn considerable attention in the health domain, as NET provides accessible solutions for long-term and continuous health monitoring and a comfortable and interactive user interface. Herein, this work offers an inaugural concise review of NET for health, encompassing approximately 70 related articles published over the past two decades and supplemented by an in-depth examination of 30 literatures from the preceding five years. This paper provides a concise analysis of health-related NET technologies from aspects of technical specifications, data processing workflows, and the practical advantages and limitations. In addition, the specific applications of NET are introduced and compared, revealing that NET is fairly influencing our lives and providing significant convenience in daily routines. Lastly, we summarize the current outcomes of NET and highlight the limitations.
Collapse
Affiliation(s)
- Lisen Zhu
- HUB of Intelligent Neuro-Engineering, Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London, London HA7 4LP, UK; (L.Z.); (J.C.); (H.Y.); (X.Z.); (R.L.)
| | - Jianan Chen
- HUB of Intelligent Neuro-Engineering, Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London, London HA7 4LP, UK; (L.Z.); (J.C.); (H.Y.); (X.Z.); (R.L.)
| | - Huixin Yang
- HUB of Intelligent Neuro-Engineering, Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London, London HA7 4LP, UK; (L.Z.); (J.C.); (H.Y.); (X.Z.); (R.L.)
- School of Instrumentation and Optoelectronics Engineering, Beihang University, Beijing 100191, China;
| | - Xinkai Zhou
- HUB of Intelligent Neuro-Engineering, Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London, London HA7 4LP, UK; (L.Z.); (J.C.); (H.Y.); (X.Z.); (R.L.)
| | - Qihang Gao
- School of Instrumentation and Optoelectronics Engineering, Beihang University, Beijing 100191, China;
| | - Rui Loureiro
- HUB of Intelligent Neuro-Engineering, Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London, London HA7 4LP, UK; (L.Z.); (J.C.); (H.Y.); (X.Z.); (R.L.)
| | - Shuo Gao
- School of Instrumentation and Optoelectronics Engineering, Beihang University, Beijing 100191, China;
| | - Hubin Zhao
- HUB of Intelligent Neuro-Engineering, Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London, London HA7 4LP, UK; (L.Z.); (J.C.); (H.Y.); (X.Z.); (R.L.)
| |
Collapse
|
3
|
Vrzáková H, Tapiala J, Iso-Mustajärvi M, Timonen T, Dietz A. Estimating Cognitive Workload Using Task-Related Pupillary Responses in Simulated Drilling in Cochlear Implantation. Laryngoscope 2024. [PMID: 38989899 DOI: 10.1002/lary.31612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/31/2024] [Accepted: 06/17/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVES Training of temporal bone drilling requires more than mastering technical skills with the drill. Skills such as visual imagery, bimanual dexterity, and stress management need to be mastered along with precise knowledge of anatomy. In otorhinolaryngology, these psychomotor skills underlie performance in the drilling of the temporal bone for access to the inner ear in cochlear implant surgery. However, little is known about how psychomotor skills and workload management impact the practitioners' continuous and overall performance. METHODS To understand how the practitioner's workload and performance unfolds over time, we examine task-evoked pupillary responses (TEPR) of 22 medical students who performed transmastoid-posterior tympanotomy (TMPT) and removal of the bony overhang of the round window niche in a 3D-printed model of the temporal bone. We investigate how students' TEPR metrics (Average Pupil Size [APS], Index of Pupil Activity [IPA], and Low/High Index of Pupillary Activity [LHIPA]) and time spent in drilling phases correspond to the performance in key drilling phases. RESULTS All TEPR measures revealed significant differences between key drilling phases that corresponded to the anticipated workload. Enlarging the facial recess lasted significantly longer than other phases. IPA captured significant increase of workload in thinning of the posterior canal wall, while APS revealed increased workload during the drilling of the bony overhang. CONCLUSION Our findings contribute to the contemporary competency-based medical residency programs where objective and continuous monitoring of participants' progress allows to track progress in expertise acquisition. Laryngoscope, 2024.
Collapse
Affiliation(s)
- Hana Vrzáková
- School of Computing, University of Eastern Finland, Joensuu, Finland
| | - Jesse Tapiala
- School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | | | - Tomi Timonen
- Department of Otorhinolaryngology, Kuopio University Hospital, Kuopio, Finland
| | - Aarno Dietz
- Department of Otorhinolaryngology, Kuopio University Hospital, Kuopio, Finland
| |
Collapse
|
4
|
Sugimoto M, Kaneko N, Oyamada M, Tomita A, Sato M. Eye-tracking analysis for situation awareness of incontinence pad changing during older adult nursing training: An observational study. Nurse Educ Pract 2024; 76:103935. [PMID: 38442654 DOI: 10.1016/j.nepr.2024.103935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 01/23/2024] [Accepted: 02/27/2024] [Indexed: 03/07/2024]
Abstract
AIM This study aims to investigate eye tracking in the practical training of incontinence pad change, which is commonly required in older adult nursing. BACKGROUND Some competencies possessed by skilled and experienced personnel are difficult to verbalize into textbooks. However, this is crucial for education, especially nursing practice education. Eye-gaze analysis is one such tool that can aid the efficient transfer of knowledge to students. Therefore, eye-gaze analysis, a novel technology for visualizing situational awareness and decision-making, has recently gained traction in healthcare. DESIGN An observation study METHODS: Ten nursing faculty members and 13 nursing students with prior incontinence pad change experience participated in this study using an older adult simulator. There were two groups of students - S1 with more recent experience in older adult care and incontinence pad changing and S2 with less. Areas of interest (AOIs) during incontinence pad preparation and fitting were determined based on gaze fixation and the time spent fixating on these areas was compared. RESULTS Students took longer than nursing faculty members. When visualizing the eye movements between the AOIs in the network, the faculty nurses and S1 alternated their gaze between the new incontinence pad and the buttocks and between other AOIs. Simultaneously, S2 tended to gaze or stare only at the new incontinence pad. CONCLUSION The presented data may help interpret visual-based situational awareness and establish effective nursing education, especially in acquiring skills that are difficult to verbalize.
Collapse
Affiliation(s)
- Masahiro Sugimoto
- Institute for Advanced Biosciences, Keio University, Tsuruoka 997-0052, Japan; Institute of Medical Sciences, Tokyo Medical University, Tokyo, Shinjuku 160-0022, Japan.
| | - Naomi Kaneko
- Faculty of Nursing, Kanagawa Institute of Technology, Kanagawa 243-0292, Japan.
| | - Michiko Oyamada
- Faculty of Human Care Department, Tohto University, 1-1 Hinode-cho, Numazu City, Shizuoka 410-0032, Japan.
| | - Atsumi Tomita
- Institute of Medical Sciences, Tokyo Medical University, Tokyo, Shinjuku 160-0022, Japan.
| | - Mitsue Sato
- Department of Nursing, Kiryu University, Midori 379-2392, Japan.
| |
Collapse
|
5
|
Feinstein M, Katz D, Demaria S, Hofer IS. Remote Monitoring and Artificial Intelligence: Outlook for 2050. Anesth Analg 2024; 138:350-357. [PMID: 38215713 PMCID: PMC10794024 DOI: 10.1213/ane.0000000000006712] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
Remote monitoring and artificial intelligence will become common and intertwined in anesthesiology by 2050. In the intraoperative period, technology will lead to the development of integrated monitoring systems that will integrate multiple data streams and allow anesthesiologists to track patients more effectively. This will free up anesthesiologists to focus on more complex tasks, such as managing risk and making value-based decisions. This will also enable the continued integration of remote monitoring and control towers having profound effects on coverage and practice models. In the PACU and ICU, the technology will lead to the development of early warning systems that can identify patients who are at risk of complications, enabling early interventions and more proactive care. The integration of augmented reality will allow for better integration of diverse types of data and better decision-making. Postoperatively, the proliferation of wearable devices that can monitor patient vital signs and track their progress will allow patients to be discharged from the hospital sooner and receive care at home. This will require increased use of telemedicine, which will allow patients to consult with doctors remotely. All of these advances will require changes to legal and regulatory frameworks that will enable new workflows that are different from those familiar to today's providers.
Collapse
Affiliation(s)
- Max Feinstein
- Department of Anesthesiology Pain and Perioperative Medicine, Icahn School of Medicine at Mount Sinai
| | - Daniel Katz
- Department of Anesthesiology Pain and Perioperative Medicine, Icahn School of Medicine at Mount Sinai
| | - Samuel Demaria
- Department of Anesthesiology Pain and Perioperative Medicine, Icahn School of Medicine at Mount Sinai
| | - Ira S. Hofer
- Department of Anesthesiology Pain and Perioperative Medicine, Icahn School of Medicine at Mount Sinai
| |
Collapse
|
6
|
Al Tuwirqi AA. Eye-Tracking Technology in Dentistry: A Review of Literature. Cureus 2024; 16:e55105. [PMID: 38558726 PMCID: PMC10978815 DOI: 10.7759/cureus.55105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
This narrative review explores the integration of eye-tracking technology in dentistry, aiming to provide a comprehensive overview of its current applications and potential benefits. The review begins by elucidating the fundamental principles of eye tracking, encompassing the various eye-tracking methods and devices commonly used in dental research. It then delves into the role of eye tracking in dental education, where the technology offers a unique perspective on students' visual attention during training and skill acquisition. Moreover, the review examines how eye tracking can aid in assessing and improving dental practitioners' clinical performance, shedding light on areas of improvement and expertise. In patient care, the application of eye-tracking technology offers significant potential. By analyzing patients' gaze patterns and visual focus during dental procedures, clinicians can gain valuable insights into their experiences, identifying sources of anxiety and discomfort. This newfound understanding can pave the way for more patient-centric care and optimized treatment plans. The review also explores the application of eye-tracking technology in designing and evaluating dental interfaces and equipment. By assessing visual ergonomics and usability, researchers can develop user-friendly instruments that enhance dental professionals' workflow and efficiency. However, despite its promise, integrating eye tracking in dentistry is not without challenges. Technical limitations, data analysis complexities, and ethical considerations require careful attention to ensure this technology's ethical and responsible use. In conclusion, this narrative review highlights the growing significance of eye-tracking technology in dentistry. Its applications span dental education, clinical practice, and patient care, holding immense potential to revolutionize how dental procedures are conducted, evaluated, and experienced. Nevertheless, further research and collaboration between dental professionals and eye-tracking experts are necessary to unlock the technology's benefits and ensure its seamless integration into dental practices.
Collapse
Affiliation(s)
- Amani A Al Tuwirqi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| |
Collapse
|
7
|
Sugimoto M, Oyamada M, Tomita A, Inada C, Sato M. Assessing the Link between Nurses' Proficiency and Situational Awareness in Neonatal Care Practice Using an Eye Tracker: An Observational Study Using a Simulator. Healthcare (Basel) 2024; 12:157. [PMID: 38255046 PMCID: PMC10815009 DOI: 10.3390/healthcare12020157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 12/28/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Nurses are expected to depend on a wide variety of visually available pieces of patient information to understand situations. Thus, we assumed a relationship between nurses' skills and their gaze trajectories. An observational study using a simulator was conducted to analyze gaze during neonatal care practice using eye tracking. We defined the face, thorax, and abdomen of the neonate, the timer, and the pulse oximeter as areas of interest (AOIs). We compared the eye trajectories for respiration and heart rate assessment between 7 experienced and 13 novice nurses. There were no statistically significant differences in the time spent on each AOI for breathing or heart rate confirmation. However, in novice nurses, we observed a significantly higher number of instances of gazing at the thorax and abdomen. The deviation in the number of instances of gazing at the face was also significantly higher among novice nurses. These results indicate that experienced and novice nurses differ in their gaze movements during situational awareness. These objective and quantitative differences in gaze trajectories may help to establish new educational tools for less experienced nurses.
Collapse
Affiliation(s)
- Masahiro Sugimoto
- Institute for Advanced Biosciences, Keio University, Tsuruoka 997-0052, Japan
- Institute of Medical Sciences, Tokyo Medical University, Shinjuku, Tokyo 160-0022, Japan;
| | - Michiko Oyamada
- Faculty of Human Care Department, Tohto University, 1-1 Hinode-cho, Numazu 410-0032, Japan;
- Department of Nursing, Nihon Institute of Medical Science, Iruma 350-0435, Japan
| | - Atsumi Tomita
- Institute of Medical Sciences, Tokyo Medical University, Shinjuku, Tokyo 160-0022, Japan;
| | - Chiharu Inada
- Faculty of Nursing, Japanese Red Cross College of Nursing, 4-1-3 Hiroo, Shibuya, Tokyo 150-0012, Japan;
| | - Mitsue Sato
- Department of Nursing, Kiryu University, Midori 379-2392, Japan;
| |
Collapse
|
8
|
Nieboer W, Ghiani A, de Vries R, Brenner E, Mann DL. Eye Tracking to Assess the Functional Consequences of Vision Impairment: A Systematic Review. Optom Vis Sci 2023; 100:861-875. [PMID: 38165789 DOI: 10.1097/opx.0000000000002088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Eye tracking is a promising method for objectively assessing functional visual capabilities, but its suitability remains unclear when assessing the vision of people with vision impairment. In particular, accurate eye tracking typically relies on a stable and reliable image of the pupil and cornea, which may be compromised by abnormalities associated with vision impairment (e.g., nystagmus, aniridia). OBJECTIVES This study aimed to establish the degree to which video-based eye tracking can be used to assess visual function in the presence of vision impairment. DATA SOURCES A systematic review was conducted using PubMed, EMBASE, and Web of Science databases, encompassing literature from inception to July 2022. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS Studies included in the review used video-based eye tracking, included individuals with vision impairment, and used screen-based tasks unrelated to practiced skills such as reading or driving. STUDY APPRAISAL AND SYNTHESIS METHODS The included studies were assessed for quality using the Strengthening the Reporting of Observational Studies in Epidemiology assessment tool. Data extraction and synthesis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Our analysis revealed that five common tests of visual function were used: (i) fixation stability, (ii) smooth pursuit, (iii) saccades, (iv) free viewing, and (v) visual search. The studies reported considerable success when testing individuals with vision impairment, yielding usable data from 96.5% of participants. LIMITATIONS There was an overrepresentation of conditions affecting the optic nerve or macula and an underrepresentation of conditions affecting the anterior segment or peripheral retina. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS The results offer promise for the use of eye tracking to assess the visual function of a considerable proportion of those with vision impairment. Based on the findings, we outline a framework for how eye tracking can be used to test visual function in the presence of vision impairment.
Collapse
Affiliation(s)
| | - Andrea Ghiani
- Department of Human Movement Sciences, Amsterdam Movement Sciences and Institute of Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Eli Brenner
- Department of Human Movement Sciences, Amsterdam Movement Sciences and Institute of Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David L Mann
- Department of Human Movement Sciences, Amsterdam Movement Sciences and Institute of Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
9
|
Tahri Sqalli M, Aslonov B, Gafurov M, Mukhammadiev N, Sqalli Houssaini Y. Eye tracking technology in medical practice: a perspective on its diverse applications. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 5:1253001. [PMID: 38045887 PMCID: PMC10691255 DOI: 10.3389/fmedt.2023.1253001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Eye tracking technology has emerged as a valuable tool in the field of medicine, offering a wide range of applications across various disciplines. This perspective article aims to provide a comprehensive overview of the diverse applications of eye tracking technology in medical practice. By summarizing the latest research findings, this article explores the potential of eye tracking technology in enhancing diagnostic accuracy, assessing and improving medical performance, as well as improving rehabilitation outcomes. Additionally, it highlights the role of eye tracking in neurology, cardiology, pathology, surgery, as well as rehabilitation, offering objective measures for various medical conditions. Furthermore, the article discusses the utility of eye tracking in autism spectrum disorders, attention-deficit/hyperactivity disorder (ADHD), and human-computer interaction in medical simulations and training. Ultimately, this perspective article underscores the transformative impact of eye tracking technology on medical practice and suggests future directions for its continued development and integration.
Collapse
Affiliation(s)
- Mohammed Tahri Sqalli
- Department of Economics, School of Foreign Services, Georgetown University in Qatar, Doha, Qatar
- Department of Engineering, New York University, Abu Dhabi, United Arab Emirates
| | - Begali Aslonov
- Department of Control and Computer Engineering, Polytechnic University of Turin, Turin, Italy
| | - Mukhammadjon Gafurov
- Department of Business Administration, Carnegie Mellon University in Qatar, Doha, Qatar
| | | | - Yahya Sqalli Houssaini
- Department of Medicine, Faculty of Medecine and Pharmacy, Mohammed V University, Rabat, Morocco
| |
Collapse
|
10
|
Galuret S, Vallée N, Tronchot A, Thomazeau H, Jannin P, Huaulmé A. Gaze behavior is related to objective technical skills assessment during virtual reality simulator-based surgical training: a proof of concept. Int J Comput Assist Radiol Surg 2023; 18:1697-1705. [PMID: 37286642 DOI: 10.1007/s11548-023-02961-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/16/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE Simulation-based training allows surgical skills to be learned safely. Most virtual reality-based surgical simulators address technical skills without considering non-technical skills, such as gaze use. In this study, we investigated surgeons' visual behavior during virtual reality-based surgical training where visual guidance is provided. Our hypothesis was that the gaze distribution in the environment is correlated with the simulator's technical skills assessment. METHODS We recorded 25 surgical training sessions on an arthroscopic simulator. Trainees were equipped with a head-mounted eye-tracking device. A U-net was trained on two sessions to segment three simulator-specific areas of interest (AoI) and the background, to quantify gaze distribution. We tested whether the percentage of gazes in those areas was correlated with the simulator's scores. RESULTS The neural network was able to segment all AoI with a mean Intersection over Union superior to 94% for each area. The gaze percentage in the AoI differed among trainees. Despite several sources of data loss, we found significant correlations between gaze position and the simulator scores. For instance, trainees obtained better procedural scores when their gaze focused on the virtual assistance (Spearman correlation test, N = 7, r = 0.800, p = 0.031). CONCLUSION Our findings suggest that visual behavior should be quantified for assessing surgical expertise in simulation-based training environments, especially when visual guidance is provided. Ultimately visual behavior could be used to quantitatively assess surgeons' learning curve and expertise while training on VR simulators, in a way that complements existing metrics.
Collapse
Affiliation(s)
- Soline Galuret
- LTSI - UMR 1099, Univ. Rennes, Inserm, 35000, Rennes, France
| | - Nicolas Vallée
- LTSI - UMR 1099, Univ. Rennes, Inserm, 35000, Rennes, France
- Orthopedics and Trauma Department, Rennes University Hospital, 35000, Rennes, France
| | - Alexandre Tronchot
- LTSI - UMR 1099, Univ. Rennes, Inserm, 35000, Rennes, France
- Orthopedics and Trauma Department, Rennes University Hospital, 35000, Rennes, France
| | - Hervé Thomazeau
- LTSI - UMR 1099, Univ. Rennes, Inserm, 35000, Rennes, France
- Orthopedics and Trauma Department, Rennes University Hospital, 35000, Rennes, France
| | - Pierre Jannin
- LTSI - UMR 1099, Univ. Rennes, Inserm, 35000, Rennes, France.
| | - Arnaud Huaulmé
- LTSI - UMR 1099, Univ. Rennes, Inserm, 35000, Rennes, France
| |
Collapse
|
11
|
Bhadila GY, Alsharif SI, Almarei S, Almashaikhi JA, Bahdila D. Visual Analysis of Panoramic Radiographs among Pediatric Dental Residents Using Eye-Tracking Technology: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1476. [PMID: 37761436 PMCID: PMC10527960 DOI: 10.3390/children10091476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023]
Abstract
The aim of this cross-sectional study was to explore the eye tracking (ET) performance of postgraduate pediatric dental students in correctly detecting abnormalities in different sets of panoramic radiographs. This observational study recruited postgraduate pediatric dental students to evaluate seven panoramic radiographs. RED-m® SMI software (Sensomotoric Instruments, Teltow, Germany) was used to track the participants' eye movements as they looked at the radiographs. The data collected for areas of interest (AOIs) included revisit counts, fixation counts, fixation times, entry times, and dwell times. Univariate and bivariate analyses were conducted to summarize the participants' characteristics and ET measures. The overall percentage of correctly located AOIs was 71.7%. The residents had significantly more revisits and fixation counts in AOIs located in one sextant than in multiple sextants (p < 0.001). Similar patterns were observed for fixation and dwell times (p < 0.001), but not for entry time. Heatmaps showed that the highest density of fixations was on the AOIs and the residents fixated more on dentition than on bony structures. In single-sextant radiographs, residents had significantly more revisits and fixation counts for AOIs compared to those of multiple sextants. Residents had slower entry times and dwelled less on AOIs located in multiple sextant(s). The reported findings can direct dental educators to develop a standardized scan scheme of panoramic radiographs to minimize misdiagnosis.
Collapse
Affiliation(s)
- Ghalia Y. Bhadila
- Department of Pediatric Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (J.A.A.); (D.B.)
| | - Safiya I. Alsharif
- General Dentist, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (S.I.A.); (S.A.)
| | - Seba Almarei
- General Dentist, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (S.I.A.); (S.A.)
| | - Jamila A. Almashaikhi
- Department of Pediatric Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (J.A.A.); (D.B.)
| | - Dania Bahdila
- Department of Pediatric Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (J.A.A.); (D.B.)
| |
Collapse
|
12
|
Bhadila GY, Alyafi DA. The Use of Eye-Tracking Technology in Pediatric Orofacial Clefts: A Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1425. [PMID: 37628424 PMCID: PMC10453381 DOI: 10.3390/children10081425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023]
Abstract
This systematic review and meta-analysis assessed the quality of the peer-reviewed literature and evaluated the usefulness of eye-tracking technology in evaluating observers' perceptions of pediatric patients with orofacial clefts. PubMed, Science Direct, Wiley, and Web of Science were searched. Articles were screened in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines, and their methodological quality was assessed. Of the 10,254 identified studies, 12 were included. Eleven studies were cross-sectional, and one was a prospective cohort study. The main areas of interest analyzed were the eyes, nose, and mouth. Nine studies used assessment scales to analyze the link between perceived attractiveness and visualization patterns and measures. For the fixation duration outcome, six studies were eligible for inclusion in the meta-analysis. All studies reported on fixation duration in milliseconds and reported on a standard deviation. The meta-analysis demonstrated a significant difference in the measurements between the control groups and the patients with orofacial clefts. This might indicate the usefulness of eye-tracking technology as a metric for assessing the success of cleft repairs based on the perceptions of different populations. Future studies should be comprehensively reported on for comparability and reproducibility purposes.
Collapse
Affiliation(s)
- Ghalia Y. Bhadila
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Dana A. Alyafi
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| |
Collapse
|
13
|
Li Y, Reed A, Kavoussi N, Wu JY. Eye gaze metrics for skill assessment and feedback in kidney stone surgery. Int J Comput Assist Radiol Surg 2023:10.1007/s11548-023-02901-6. [PMID: 37202714 DOI: 10.1007/s11548-023-02901-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/31/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE Surgical skill assessment is essential for safe operations. In endoscopic kidney stone surgery, surgeons must perform a highly skill-dependent mental mapping from the pre-operative scan to the intraoperative endoscope image. Poor mental mapping can lead to incomplete exploration of the kidney and high reoperation rates. Yet there are few objective ways to evaluate competency. We propose to use unobtrusive eye-gaze measurements in the task space to evaluate skill and provide feedback. METHODS We capture the surgeons' eye gaze on the surgical monitor with the Microsoft Hololens 2. To enable stable and accurate gaze detection, we develop a calibration algorithm to refine the eye tracking of the Hololens. In addition, we use a QR code to locate the eye gaze on the surgical monitor. We then run a user study with three expert and three novice surgeons. Each surgeon is tasked to locate three needles representing kidney stones in three different kidney phantoms. RESULTS We find that experts have more focused gaze patterns. They complete the task faster, have smaller total gaze area, and the gaze fewer times outside the area of interest. While fixation to non-fixation ratio did not show significant difference in our findings, tracking the ratio over time shows different patterns between novices and experts. CONCLUSION We show that a non-negligible difference holds between novice and expert surgeons' gaze metrics in kidney stone identification in phantoms. Expert surgeons demonstrate more targeted gaze throughout a trial, indicating their higher level of proficiency. To improve the skill acquisition process for novice surgeons, we suggest providing sub-task specific feedback. This approach presents an objective and non-invasive method to assess surgical competence.
Collapse
Affiliation(s)
- Yizhou Li
- Department of Computer Science, Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN, 37240, USA.
| | - Amy Reed
- Department of Urology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN, 37232, USA
| | - Nicholas Kavoussi
- Department of Urology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN, 37232, USA
| | - Jie Ying Wu
- Department of Computer Science, Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN, 37240, USA.
| |
Collapse
|
14
|
Laubrock J, Krutz A, Nübel J, Spethmann S. Gaze patterns reflect and predict expertise in dynamic echocardiographic imaging. J Med Imaging (Bellingham) 2023; 10:S11906. [PMID: 36968293 PMCID: PMC10031643 DOI: 10.1117/1.jmi.10.s1.s11906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/01/2023] [Indexed: 03/24/2023] Open
Abstract
Purpose Echocardiography is the most important modality in cardiac imaging. Rapid valid visual assessment is a critical skill for image interpretation. However, it is unclear how skilled viewers assess echocardiographic images. Therefore, guidance and implicit advice are needed for learners to achieve valid image interpretation. Approach Using a signal detection approach, we compared 15 certified experts with 15 medical students in their diagnostic decision-making and viewing behavior. To quantify attention allocation, we recorded eye movements while viewing dynamic echocardiographic imaging loops of patients with reduced ejection fraction and healthy controls. Participants evaluated left ventricular ejection fraction and image quality (as diagnostic and visual control tasks, respectively). Results Experts were much better at discriminating between patients and healthy controls (d ' of 2.58, versus 0.98 for novices). Eye tracking revealed that experts fixated diagnostically relevant areas earlier and more often, whereas novices were distracted by visually salient task-irrelevant stimuli. We show that expertise status can be almost perfectly classified either based on judgments or purely on eye movements and that an expertise score derived from viewing behavior predicts diagnostic quality. Conclusions Judgments and eye tracking revealed significant differences between echocardiography experts and novices that can be used to derive numerical expertise scores. Experts have implicitly learned to ignore the salient motion cue presented by the mitral valve and to focus on the diagnostically more relevant left ventricle. These findings have implications for echocardiography training, objective characterization of echocardiographic expertise, and the design of user-friendly interfaces for echocardiography.
Collapse
Affiliation(s)
- Jochen Laubrock
- University of Potsdam, Cognitive Science, Department of Psychology, Potsdam, Germany
| | - Alexander Krutz
- Heart Centre Brandenburg, Department of Cardiology, Bernau, Germany
- Brandenburg Medical School Theodor Fontane, Faculty of Health Sciences Brandenburg, Neuruppin, Germany
| | - Jonathan Nübel
- Heart Centre Brandenburg, Department of Cardiology, Bernau, Germany
- Brandenburg Medical School Theodor Fontane, Faculty of Health Sciences Brandenburg, Neuruppin, Germany
| | - Sebastian Spethmann
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology, and Intensive Care Medicine, Berlin, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| |
Collapse
|