Face-to-face vs. remote digital settings in job assessment interviews: A multilevel hyperscanning protocol for the investigation of interpersonal attunement.

The digitalization process for organizations, which was inevitably accelerated by the COVID-19 pandemic, raises relevant challenges for Human Resource Management (HRM) because every technological implementation has a certain impact on human beings. Between many organizational HRM practices, recruitment and assessment interviews represent a significant moment where a social interaction provides the context for evaluating candidates' skills. It is therefore relevant to investigate how different interaction frames and relational conditions affect such task, with a specific focus on the differences between face-to-face (FTF) and remote computer-mediated (RCM) interaction settings. In particular, the possibility of qualifying and quantifying the mechanisms shaping the efficiency of interaction in the recruiter-candidate dyad-i.e. interpersonal attunement-is potentially insightful. We here present a neuroscientific protocol aimed at elucidating the impact of FTF vs. RCM modalities on social dynamics within assessment interviews. Specifically, the hyperscanning approach, understood as the concurrent recording and integrated analysis of behavioural-physiological responses of interacting agents, will be used to evaluate recruiter-candidate dyads while they are involved in either FTF or RCM conditions. Specifically, the protocol has been designed to collect self-report, oculometric, autonomic (electrodermal activity, heart rate, heart rate variability), and neurophysiological (electroencephalography) metrics from both inter-agents to explore the perceived quality of the interaction, automatic visual-attentional patterns of inter-agents, as well as their cognitive workload and emotional engagement. The proposed protocol will provide a theoretical evidence-based framework to assess possible differences between FTF vs. RMC settings in complex social interactions, with a specific focus on job interviews.

Home- and Office-Based Vergence and Accommodative Therapies for Treatment of Convergence Insufficiency in Children and Young Adults: A Report by the American Academy of Ophthalmology.

PURPOSE: To review home- and office-based vergence and accommodative therapies for treatment of convergence insufficiency (CI) in children and young adults up to 35 years of age. METHODS: Literature searches were conducted through October 2020 in the PubMed database for English-language studies. The combined searches yielded 359 abstracts, of which 37 were reviewed in full text. Twelve of these were considered appropriate for inclusion in this assessment and assigned a level of evidence rating by the panel methodologist. RESULTS: Of the 12 studies included in this assessment, 8 were graded as level I evidence, 2 were graded as level II evidence, and 2 were graded as level III evidence. Two of the level I studies included older teenagers and young adults; the remainder of the studies exclusively evaluated children. Two randomized controlled trials found that office-based vergence and accommodative therapies were effective in improving motor outcomes in children with symptomatic CI. However, the studies reported conflicting results on the efficacy of office-based therapy for treating symptoms of CI. Data were inconclusive regarding the effectiveness of home-based therapies (including pencil push-ups and home computer therapy) compared with home placebo. In young adults, office-based vergence and accommodative therapies were not superior to placebo in relieving symptoms of CI. CONCLUSIONS: Level I evidence suggests that office-based vergence and accommodative therapies improve motor outcomes in children with symptomatic CI, although data are inconsistent regarding symptomatic relief. Evidence is insufficient to determine whether home-based therapies are effective.

Acute-onset binocular diplopia in neurological unit: Aetiological factors and diagnostic assessment.

OBJECTIVES: To investigate the aetiology of acute-onset binocular diplopia (AOBD) in neurological units and identify the key diagnostic procedures in this setting. MATERIALS AND METHODS: Clinico-demographic data from patients hospitalized for AOBD from 2008 to 2019 were retrospectively reviewed. AOBD due to an underlying neurological disorder known to cause diplopia was addressed as secondary diplopia. Ophthalmoparesis plus was defined when subtle neurological signs/symptoms other than ophthalmoparesis were detected during neurological examination. RESULTS: A total of 171 patients (mean age 57.6 years) were included in the study. A total of 89 subjects (52%) had an oculomotor disturbance consistent with sixth nerve palsy, and 42 (24.6%) showed multiple oculomotor nerve involvement. The most common cause of AOBD was presumed to be microvascular in 56 patients (32.7%), while a secondary aetiology was identified in 102 (59.6%). Ophthalmoparesis plus and multiple oculomotor nerve involvement significantly predicted a secondary aetiology in multivariable logistic regression analysis. Brain CT was never diagnostic in isolated ophthalmoparesis. A combination of neuroimaging examinations established AOBD diagnosis in 54.9% of subjects, whereas rachicentesis and neurophysiological examinations were found to be performant in the remaining cases. CONCLUSIONS: AOBD may herald insidious neurological disease, and an extensive diagnostic workup is often needed to establish a diagnosis. Neurological examination was pivotal in identifying patients at higher risk of secondary aetiology. Even in cases of apparently benign presentation, a serious underlying disease cannot be excluded. Brain MRI was found to perform well in all clinical scenarios, and it should be always considered when managing AOBD.

Visual scanning strategies in the cockpit are modulated by pilots' expertise: A flight simulator study.

During a flight, pilots must rigorously monitor their flight instruments since it is one of the critical activities that contribute to update their situation awareness. The monitoring is cognitively demanding, but is necessary for timely intervention in the event of a parameter deviation. Many studies have shown that a large part of commercial aviation accidents involved poor cockpit monitoring from the crew. Research in eye-tracking has developed numerous metrics to examine visual strategies in fields such as art viewing, sports, chess, reading, aviation, and space. In this article, we propose to use both basic and advanced eye metrics to study visual information acquisition, gaze dispersion, and gaze patterning among novices and pilots. The experiment involved a group of sixteen certified professional pilots and a group of sixteen novice during a manual landing task scenario performed in a flight simulator. The two groups landed three times with different levels of difficulty (manipulated via a double task paradigm). Compared to novices, professional pilots had a higher perceptual efficiency (more numerous and shorter dwells), a better distribution of attention, an ambient mode of visual attention, and more complex and elaborate visual scanning patterns. We classified pilot's profiles (novices-experts) by machine learning based on Cosine KNN (K-Nearest Neighbors) using transition matrices. Several eye metrics were also sensitive to the landing difficulty. Our results can benefit the aviation domain by helping to assess the monitoring performance of the crews, improve initial and recurrent training and ultimately reduce incidents, and accidents due to human error.

Parafoveal degradation during reading reduces preview costs only when it is not perceptually distinct.

There is a growing understanding that the parafoveal preview effect during reading may represent a combination of preview benefits and preview costs due to interference from parafoveal masks. It has been suggested that visually degrading the parafoveal masks may reduce their costs, but adult readers were later shown to be highly sensitive to degraded display changes. Four experiments examined how preview benefits and preview costs are influenced by the perception of distinct parafoveal degradation at the target word location. Participants read sentences with four preview types (identity, orthographic, phonological, and letter-mask preview) and two levels of visual degradation (0% vs. 20%). The distinctiveness of the target word degradation was either eliminated by degrading all words in the sentence (Experiments 1a-2a) or remained present, as in previous research (Experiments 1b-2b). Degrading the letter masks resulted in a reduction in preview costs, but only when all words in the sentence were degraded. When degradation at the target word location was perceptually distinct, it induced costs of its own, even for orthographically and phonologically related previews. These results confirm previous reports that traditional parafoveal masks introduce preview costs that overestimate the size of the true benefit. However, they also show that parafoveal degradation has the unintended consequence of introducing additional costs when participants are aware of distinct degradation on the target word. Parafoveal degradation appears to be easily perceived and may temporarily orient attention away from the reading task, thus delaying word processing.

Learning Scan Paths of Eye Movement in Autism Spectrum Disorder.

Eye tracking studies have demonstrated deficits in attention in individuals with Autism Spectrum Disorder (ASD) for a range of different social attention-based tasks. Here we examined social attention skills in a large sample of ASD participants (n = 120), using eye tracking data from a social information processing task, and compared them with a typically developing (TD) group (n = 35). Assuming eye movement parameters are random variables generated by an underlying stochastic process, we modeled the fixation sequences of participants in ASD and TD groups with a Hidden Markov Model. The Regions of Interests (ROIs), modeled as hidden states, corresponded to the true ROIs with a prediction accuracy of >90% for each group. The transition between ROIs revealed bias towards a specific area in the scene in ASD group, which deviated from the TD group. Objective time-dynamic measures of gaze patterns can potentially serve as useful endpoints in ASD diagnosis. Clinical Trial Registration: NCT02299700.

Understanding visual attention to face emotions in social anxiety using hidden Markov models.

Theoretical models propose that attentional biases might account for the maintenance of social anxiety symptoms. However, previous eye-tracking studies have yielded mixed results. One explanation is that existing studies quantify eye-movements using arbitrary, experimenter-defined criteria such as time segments and regions of interests that do not capture the dynamic nature of overt visual attention. The current study adopted the Eye Movement analysis with Hidden Markov Models (EMHMM) approach for eye-movement analysis, a machine-learning, data-driven approach that can cluster people's eye-movements into different strategy groups. Sixty participants high and low in self-reported social anxiety symptoms viewed angry and neutral faces in a free-viewing task while their eye-movements were recorded. EMHMM analyses revealed novel associations between eye-movement patterns and social anxiety symptoms that were not evident with standard analytical approaches. Participants who adopted the same face-viewing strategy when viewing both angry and neutral faces showed higher social anxiety symptoms than those who transitioned between strategies when viewing angry versus neutral faces. EMHMM can offer novel insights into psychopathology-related attention processes.

Difference in eye movements during gait analysis between professionals and trainees.

INTRODUCTION: Observational gait analysis is a widely used skill in physical therapy. Meanwhile, the skill has not been investigated using objective assessments. The present study investigated the differences in eye movement between professionals and trainees, while observing gait analysis. METHODS: The participants included in this study were 26 professional physical therapists and 26 physical therapist trainees. The participants, wearing eye tracker systems, were asked to describe gait abnormalities of a patient as much as possible. The eye movement parameters of interest were fixation count, average fixation duration, and total fixation duration. RESULTS: The number of gait abnormalities described was significantly higher in professionals than in trainees, overall and in limbs of the patient. The fixation count was significantly higher in professionals when compared to trainees. Additionally, the average fixation duration and total fixation duration were significantly shorter in professionals. Conversely, in trunks, the number of gait abnormalities and eye movements showed no significant differences between groups. CONCLUSIONS: Professionals require shorter fixation durations on areas of interest than trainees, while describing a higher number of gait abnormalities.

Gaze Tracking and Point Estimation Using Low-Cost Head-Mounted Devices.

In this study, a head-mounted device was developed to track the gaze of the eyes and estimate the gaze point on the user's visual plane. To provide a cost-effective vision tracking solution, this head-mounted device is combined with a sized endoscope camera, infrared light, and mobile phone; the devices are also implemented via 3D printing to reduce costs. Based on the proposed image pre-processing techniques, the system can efficiently extract and estimate the pupil ellipse from the camera module. A 3D eye model was also developed to effectively locate eye gaze points from extracted eye images. In the experimental results, average accuracy, precision, and recall rates of the proposed system can achieve an average of over 97%, which can demonstrate the efficiency of the proposed system. This study can be widely used in the Internet of Things, virtual reality, assistive devices, and human-computer interaction applications.

Gaze and Movement Assessment (GaMA): Inter-site validation of a visuomotor upper limb functional protocol.

BACKGROUND: Successful hand-object interactions require precise hand-eye coordination with continual movement adjustments. Quantitative measurement of this visuomotor behaviour could provide valuable insight into upper limb impairments. The Gaze and Movement Assessment (GaMA) was developed to provide protocols for simultaneous motion capture and eye tracking during the administration of two functional tasks, along with data analysis methods to generate standard measures of visuomotor behaviour. The objective of this study was to investigate the reproducibility of the GaMA protocol across two independent groups of non-disabled participants, with different raters using different motion capture and eye tracking technology. METHODS: Twenty non-disabled adults performed the Pasta Box Task and the Cup Transfer Task. Upper body and eye movements were recorded using motion capture and eye tracking, respectively. Measures of hand movement, angular joint kinematics, and eye gaze were compared to those from a different sample of twenty non-disabled adults who had previously performed the same protocol with different technology, rater and site. RESULTS: Participants took longer to perform the tasks versus those from the earlier study, although the relative time of each movement phase was similar. Measures that were dissimilar between the groups included hand distances travelled, hand trajectories, number of movement units, eye latencies, and peak angular velocities. Similarities included all hand velocity and grip aperture measures, eye fixations, and most peak joint angle and range of motion measures. DISCUSSION: The reproducibility of GaMA was confirmed by this study, despite a few differences introduced by learning effects, task demonstration variation, and limitations of the kinematic model. GaMA accurately quantifies the typical behaviours of a non-disabled population, producing precise quantitative measures of hand function, trunk and angular joint kinematics, and associated visuomotor behaviour. This work advances the consideration for use of GaMA in populations with upper limb sensorimotor impairment.

Proof of Concept of an Assistive Robotic Arm Control Using Artificial Stereovision and Eye-Tracking.

Assistive robotic arms have become popular to help users with upper limb disabilities achieve autonomy in their daily tasks, such as drinking and grasping objects in general. Usually, these robotic arms are controlled with an adapted joystick. Joysticks are user-friendly when it comes to a general approach to an object. However, they are not as intuitive when having to accurately approach an object, especially when obstacles are present. Alternatively, the combined use of artificial stereovision and eye-tracking seems to be a promising solution, as the user's vision is usually dissociated from their upper limb disability. Hence, the objective of this study was to develop a proof of concept for the control of an assistive robotic arm using a low-cost combination of stereovision and eye-tracking. Using the developed control system, a typically developed person was able to control the robotic arm successfully reaching and grasping an object for 92% of the trials without obstacles with an average time of 13.8 seconds. Then, another set of trials with one obstacle had a success rate of 91% with an average time of 17.3 seconds. Finally, the last set of trials with two obstacles had a success rate of 98% with an average time of 18.4 seconds. Furthermore, the cost of an eye-tracker and stereovision remains below 400$.

Objective and quantitative assessment of interocular suppression in strabismic amblyopia based on steady-state motion visual evoked potentials.

In this study, we aimed to explore an objective, sensitive and quantitative measurement of interocular suppression in strabismic amblyopia. We compared 11 strabismic subjects with 12 normal vision subjects to explore the different response characterizations in normal eyes, nondominant and dominant eyes of strabismic subjects by using steady-state motion visual evoked potentials (SSMVEPs). Stimulation at different temporal frequencies was presented to two eyes by using an interocular dichoptic technique. Furthermore, canonical correlation analysis (CCA), signal-to-noise ratio (SNR) and some statistical methods, such as the paired t-test, analysis of variance (ANOVA) and correlation analysis, were used to analyze electroencephalography (EEG) signals. We proposed two indices-divergence J and suppression imbalance (SI) to describe the deficits in interocular suppression-and one index - mask attenuation coefficient (MAC)- to describe the influence of a dichoptic mask from the dominant eyes to nondominant eyes of strabismic subjects. A significant difference was found between nondominant and dominant eyes of strabismic subjects in SSMVEP response and SNR value while no apparent difference was observed between the two eyes in subjects with normal vision. There was a strong linear correlation between divergence J, SI and visual acuity difference of two eyes both in strabismic amblyopia and normal vision. A linear correlation was also found between visual acuity difference and MAC in patients with strabismic amblyopia. Our findings suggest that SSMVEPs can be an objective and quantitative method for measuring the interocular suppression in strabismus and assessing the deficits of strabismic amblyopia.

Novel Method for Rapid Assessment of Cognitive Impairment Using High-Performance Eye-Tracking Technology.

A rapid increase in the number of patients with dementia has emerged as a global health challenge. Accumulating evidence suggests that early diagnosis and timely intervention can delay cognitive decline. The diagnosis of dementia is commonly performed using neuropsychological tests, such as the Mini-Mental State Examination (MMSE), administered by trained examiners. While these traditional neuropsychological tests are valid and reliable, they are neither simple nor sufficiently short as routine screening tools for dementia. Here, we developed a brief cognitive assessment utilizing an eye-tracking technology. The subject views a series of short (178 s) task movies and pictures displayed on a monitor while their gaze points are recorded by the eye-tracking device, and the cognitive scores are determined from the gaze plots data. The cognitive scores were measured by both an eye tracking-based assessment and neuropsychological tests in 80 participants, including 27 cognitively healthy controls (HC), 26 patients with mild cognitive impairment (MCI), and 27 patients with dementia. The eye tracking-based cognitive scores correlated well with the scores from the neuropsychological tests, and they showed a good diagnostic performance in detecting patients with MCI and dementia. Rapid cognitive assessment using eye-tracking technology can enable quantitative scoring and the sensitive detection of cognitive impairment.

An investigation into the diagnostic accuracy, reliability, acceptability and safety of a novel device for Continuous Ambulatory Vestibular Assessment (CAVA).

Dizziness is a common condition that is responsible for a significant degree of material morbidity and burden on health services. It is usually episodic and short-lived, so when a patient presents to their clinician, examination is normal. The CAVA (Continuous Ambulatory Vestibular Assessment) device has been developed to provide continuous monitoring of eye-movements, allowing insight into the physiological parameters present during a dizziness attack. This article describes the first clinical investigation into the medical and technical aspects of this new diagnostic system. Seventeen healthy subjects wore the device near continuously for up to thirty days, artificially inducing nystagmus on eight occasions. 405 days' worth of data was captured, comprising around four billion data points. A computer algorithm developed to detect nystagmus demonstrated a sensitivity of 99.1% (95% CI: 95.13% to 99.98%) and a specificity of 98.6% (95% CI: 96.54% to 99.63%). Eighty-two percent of participants wore the device for a minimum of eighty percent of each day. Adverse events were self-limiting and mostly the consequence of skin stripping from the daily replacement of the electrodes. The device was shown to operate effectively as an ambulatory monitor, allowing the reliable detection of artificially induced nystagmus.

Treating repetitive suicidal intrusions using eye movements: study protocol for a multicenter randomized clinical trial.

BACKGROUND: Suicide is a major public health problem, and it remains unclear which processes link suicidal ideation and plans to the act of suicide. Growing evidence shows that the majority of suicidal patients diagnosed with major depression or bipolar disorder report repetitive suicide-related images and thoughts (suicidal intrusions). Various studies showed that vividness of negative as well as positive intrusive images may be reduced by dual task (e.g. eye movements) interventions taxing the working memory. We propose that a dual task intervention may also reduce frequency and intensity of suicidal imagery and may be crucial in preventing the transition from suicidal ideation and planning to actual suicidal behaviour. This study aims a) to evaluate the effectiveness of an Eye Movement Dual Task (EMDT) add-on intervention targeting suicidal imagery in depressed patients, b) to explore the role of potential moderators and mediators in explaining the effect of EMDT, and c) to evaluate the cost-effectiveness of EMDT. METHODS: We will conduct a multi-center randomized clinical trial (RCT) evaluating the effects of EMDT in combination with usual care (n = 45) compared to usual care alone (n = 45). Participants will fill in multiple online batteries of self-report questionnaires as well as complete a semi-structured interview (Intrusion Interview), and online computer tasks. The primary outcome is the frequency and intrusiveness of suicidal imagery. Furthermore, the vividness, emotionality, and content of the suicidal intrusions are evaluated; secondary outcomes include: suicidal behaviour and suicidal ideation, severity of depression, psychological symptoms, rumination, and hopelessness. Finally, potential moderators and mediators are assessed. DISCUSSION: If proven effective, EMDT can be added to regular treatment to reduce the frequency and vividness of suicidal imagery. TRIAL REGISTRATION: The study has been registered on October 17th, 2018 at the Netherlands Trial Register, part of the Dutch Cochrane Centre ( NTR7563 ).

A Novel Eye Movement Data Transformation Technique that Preserves Temporal Information: A Demonstration in a Face Processing Task.

Existing research has shown that human eye-movement data conveys rich information about underlying mental processes, and that the latter may be inferred from the former. However, most related studies rely on spatial information about which different areas of visual stimuli were looked at, without considering the order in which this occurred. Although powerful algorithms for making pairwise comparisons between eye-movement sequences (scanpaths) exist, the problem is how to compare two groups of scanpaths, e.g., those registered with vs. without an experimental manipulation in place, rather than individual scanpaths. Here, we propose that the problem might be solved by projecting a scanpath similarity matrix, obtained via a pairwise comparison algorithm, to a lower-dimensional space (the comparison and dimensionality-reduction techniques we use are ScanMatch and t-SNE). The resulting distributions of low-dimensional vectors representing individual scanpaths can be statistically compared. To assess if the differences result from temporal scanpath features, we propose to statistically compare the cross-validated accuracies of two classifiers predicting group membership: (1) based exclusively on spatial metrics; (2) based additionally on the obtained scanpath representation vectors. To illustrate, we compare autistic vs. typically-developing individuals looking at human faces during a lab experiment and find significant differences in temporal scanpath features.

Surgery-free video-oculography in mouse models: enabling quantitative and short-interval longitudinal assessment of vestibular function.

Vestibulo-ocular reflex (VOR) responding to acceleration stimuli is originated from the vestibular apparatuses and thus widely used as an in vivo indicator of the vestibular function. We have developed a vestibular function testing (VFT) system that allows to evaluate VOR response with improved efficiency. The previously required surgical procedure has been avoided by using a newly designed animal-immobility setup. The efficacy of our VFT system was demonstrated on the mice with vestibular abnormalities caused by either genetic mutations (Lhfpl5-/- or Cdh23-/-) or applied vestibulotoxicant (3,3'-iminodipropionitrile, IDPN). Daily longitudinal inspection of the VOR response in the IDPN-administered mice gives the first VOR-based daily-progression profile of the vestibular impairment. The capability of VOR in quantifying the severity of toxicant-induced vestibular deficits has been also demonstrated. The acquired VOR-measurement results were validated against the corresponding behavioral-test results. Further validation against immunofluorescence microscopy was applied to the VOR data obtained from the IDPN-administered mice. We conclude that the improved efficiency of our surgery-free VFT system, firstly, enables the characterization of VOR temporal dynamics and quantification of vestibular-impairment severity that may reveal useful information in toxicological and/or pharmaceutical studies; and, secondly, confers our system promising potential to serve as a high-throughput screener for identifying genes and drugs that affect vestibular function.

Does it look safe? An eye tracking study into the visual aspects of fear of crime.

Studies of fear of crime often focus on demographic and social factors, but these can be difficult to change. Studies of visual aspects have suggested that features reflecting incivilities, such as litter, graffiti, and vandalism increase fear of crime, but methods often rely on participants actively mentioning such aspects, and more subtle, less conscious aspects may be overlooked. To address these concerns, this study examined people's eye movements while they judged scenes for safety. In total, 40 current and former university students were asked to rate images of day-time and night-time scenes of Lincoln, UK (where they studied) and Egham, UK (unfamiliar location) for safety, maintenance, and familiarity while their eye movements were recorded. Another 25 observers not from Lincoln or Egham rated the same images in an Internet survey. Ratings showed a strong association between safety and maintenance and lower safety ratings for night-time scenes for both groups, in agreement with earlier findings. Eye movements of the Lincoln participants showed increased dwell times on buildings, houses, and vehicles during safety judgements and increased dwell times on streets, pavements, and markers of incivilities for maintenance. Results confirm that maintenance plays an important role in perceptions of safety, but eye movements suggest that observers also look for indicators of current or recent presence of people.

Examining sensory ability, feature matching and assessment-based adaptation for a brain-computer interface using the steady-state visually evoked potential.

PURPOSE: We investigated how overt visual attention and oculomotor control influence successful use of a visual feedback brain-computer interface (BCI) for accessing augmentative and alternative communication (AAC) devices in a heterogeneous population of individuals with profound neuromotor impairments. BCIs are often tested within a single patient population limiting generalization of results. This study focuses on examining individual sensory abilities with an eye toward possible interface adaptations to improve device performance. METHODS: Five individuals with a range of neuromotor disorders participated in four-choice BCI control task involving the steady state visually evoked potential. The BCI graphical interface was designed to simulate a commercial AAC device to examine whether an integrated device could be used successfully by individuals with neuromotor impairment. RESULTS: All participants were able to interact with the BCI and highest performance was found for participants able to employ an overt visual attention strategy. For participants with visual deficits to due to impaired oculomotor control, effective performance increased after accounting for mismatches between the graphical layout and participant visual capabilities. CONCLUSION: As BCIs are translated from research environments to clinical applications, the assessment of BCI-related skills will help facilitate proper device selection and provide individuals who use BCI the greatest likelihood of immediate and long term communicative success. Overall, our results indicate that adaptations can be an effective strategy to reduce barriers and increase access to BCI technology. These efforts should be directed by comprehensive assessments for matching individuals to the most appropriate device to support their complex communication needs. Implications for Rehabilitation Brain computer interfaces using the steady state visually evoked potential can be integrated with an augmentative and alternative communication device to provide access to language and literacy for individuals with neuromotor impairment. Comprehensive assessments are needed to fully understand the sensory, motor, and cognitive abilities of individuals who may use brain-computer interfaces for proper feature matching as selection of the most appropriate device including optimization device layouts and control paradigms. Oculomotor impairments negatively impact brain-computer interfaces that use the steady state visually evoked potential, but modifications to place interface stimuli and communication items in the intact visual field can improve successful outcomes.

Estimating the Reliability of Glaucomatous Visual Field for the Accurate Assessment of Progression Using the Gaze-Tracking and Reliability Indices.

PURPOSE: To investigate the usefulness of visual field (VF) reliability indices and gaze tracking (GT) for the accurate assessment of progression in glaucoma. DESIGN: Institutional practice. PARTICIPANTS: Four hundred eighty-three eyes of 304 patients with open-angle glaucoma. METHODS: In each eye, a series of 10 VFs were examined. Using the GT chart at the bottom of the VF printout (Humphrey Field Analyzer, Swedish interactive threshold algorithm standard), average tracking failure frequency (TFF), average blinking frequency (BF), and the total amount of eye movement per stimulus (MPS) were calculated. Mean total deviation (mTD) was calculated based on the 52 total deviation values in each 24-2 VF, and linear regression was applied to the series of mTD measurements over time. Progression was deemed to have occurred based on 2 separate definitions: (1) the mTD rate across all 10 VFs (VF1-10) was significant (P < 0.05) and less than 0 dB/year and (2) the mTD rate was less than -0.5 dB/year and significant at P < 0.05. The mTD rate also was calculated in shorter VF series (VF1-5-VF1-9). The area under the receiver operating characteristic curve (AUC) was calculated from the relationship between mTD rates of shorter VF series (n < 10) and the diagnosis of progression in all 10 VFs. This analysis was iterated after excluding eyes with increasingly strict cutoff values for the standard VF reliability indices (fixation loss [FL], false-positive [FP] rate, and false-negative [FN] rate) and the GT parameters (TFF, BF, and MPS). MAIN OUTCOME MEASURES: Area under the receiver operating characteristic curve values with different exclusion criteria for GT and standard reliability indices. RESULTS: The AUC was largely unchanged according to stricter FL and FP criteria. The AUC increased with a more stringent FN criterion, but only when progression was described using the second definition (a rate of less than -0.5 dB/year). The AUC increased with stricter criteria for TFF, BF, and, to some extent, MPS. CONCLUSIONS: Mean total deviation progression rates are more reliable when FN, TFF, BF, and MPS indices are stricter. Gaze-tracking results should be considered when assessing glaucomatous progression.