Effects of levels of automation and non-driving related tasks on driver performance and workload: A review of literature and meta-analysis

This study assessed the effects of different levels of automation and non-driving related tasks (NDRT) on driver performance and workload. A systematic literature review was conducted in March 2021 using Compendex, Google Scholar, Web of Science, and Scopus databases. Forty-five studies met the inclusion criteria. A meta-analysis was conducted and Cochrane risk of bias tool and Cochran's Q test were used to assess risk of bias and homogeneity of the effect sizes respectively. Results suggested that drivers exhibited safer performance when dealing with critical incidents in manual driving than partially automated driving (PAD) and highly automated driving (HAD) conditions. However, drivers reported higher workload in the manual driving mode as compared to the HAD and PAD conditions. Haptic, auditory, and visual-auditory takeover request modalities are preferred over the visual-only modality to improve takeover time. Use of handheld NDRTs significantly degraded driver performance as compared to NDRTs performed on mounted devices.

The interaction effects of automation and population aging on labor market

Automation and population aging are two major forces that will shape the nature of works in the future. However, it is not clear how these forces will interact with each other and affect the labor market. This paper examines the interaction effects of computerization and population aging on the labor market. We found that computerization and population aging have large and statistically significant effects on employment growth but not earnings growth. Also, their interaction terms are statistically significant only for employment growth but not for earnings growth.

Prevalence, types and severity of medication errors associated with the use of automated medication use systems in ambulatory and institutionalized care settings: A systematic review protocol

The use of automated systems within the medication use process has significantly reduce the occurrence of medication errors and the associated clinical and financial burden. However, automated systems lull into a false sense of security and increase the risk of medication errors that are often associated with socio-technical interactions, automation bias, workarounds and overrides. The objective of the systematic review is to determine the prevalence, types and severity of medication errors that are associated the use of automated systems in ambulatory and institutionalized care settings. The search strategy will be guided by PRISMA framework. Selected databases and relevant gray literature were searched and screening was done independently by two researchers between 01 April and 29 June 2021. These covered all relevant articles published from the inception of the use of automation in the medication use process (2000) until 2020. De-duplication and screening of all studies were done independently by two researchers with a clear inclusion / exclusion criteria. Data extraction and synthesis are currently on going (started on 06 July 2021) and being conducted independently but the validity and completeness of the processes will be confirmed by the third researcher. The Cochrane Risk of Bias tool and the Hoy et al's quality assessment checklist will be used for the assessment of methodological bias while the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system will be used for the quality of evidence assessment. Detailed qualitative synthesis of key findings will be done with thematic and descriptive analyses. If the number and types of included studies permit, fixed or random effect model meta-analysis will be conducted based on the degree of homogeneity in the sampling frame used in the included studies. Heterogeneity will be assessed with I2 statistics and I2 > 50% will be considered a high statistical heterogeneity. The systematic review may provide new perspective especially from developing settings about the prevalence, types and severity of medication errors associated with the use of automated systems at all the stages of medication use process, and in all categories of patients. This may add to global knowledge in the research area. Systematic review registration: The systematic review was registered and published by PROSPERO (CRD42020212900).

Automated office BP measurement: The new standard in HTN screening

Obtain greater accuracy in blood pressure measurement with an automated office device.

What humanlike errors do autonomous vehicles need to avoid to maximize safety?

INTRODUCTION

The final failure in the causal chain of events in 94% of crashes is driver error. It is assumed most crashes will be prevented by autonomous vehicles (AVs), but AVs will still crash if they make the same mistakes as humans. By identifying the distribution of crashes among various contributing factors, this study provides guidance on the roles AVs must perform and errors they must avoid to realize their safety potential.

METHOD

Using the NMVCCS database, five categories of driver-related contributing factors were assigned to crashes: (1) sensing/perceiving (i.e., not recognizing hazards); (2) predicting (i.e., misjudging behavior of other vehicles); (3) planning/deciding (i.e., poor decision-making behind traffic law adherence and defensive driving); (4) execution/performance (i.e., inappropriate vehicle control); and (5) incapacitation (i.e., alcohol-impaired or otherwise incapacitated driver). Assuming AVs would have superior perception and be incapable of incapacitation, we determined how many crashes would persist beyond those with incapacitation or exclusively sensing/perceiving factors.

RESULTS

Thirty-three percent of crashes involved only sensing/perceiving factors (23%) or incapacitation (10%). If they could be prevented by AVs, 67% could remain, many with planning/deciding (41%), execution/performance (23%), and predicting (17%) factors. Crashes with planning/deciding factors often involved speeding (23%) or illegal maneuvers (15%).

CONCLUSIONS

Errors in choosing evasive maneuvers, predicting actions of other road users, and traveling at speeds suitable for conditions will persist if designers program AVs to make errors similar to those of today's human drivers. Planning/deciding factors, such as speeding and disobeying traffic laws, reflect driver preferences, and AV design philosophies will need to be consistent with safety rather than occupant preferences when they conflict. Practical applications: This study illustrates the complex roles AVs will have to perform and the risks arising from occupant preferences that AV designers and regulators must address if AVs will realize their potential to eliminate most crashes.

Pediatric occupant human body model kinematic and kinetic response variation to changes in seating posture in simulated frontal impacts - with and without automatic emergency braking

OBJECTIVE

The study quantifies the kinematics of children in booster child restraint systems (CRSs) in various naturalistic seating postures exposed to frontal impacts in a full-vehicle environment, with and without the application of pre-crash automatic emergency braking.

METHODS

The PIPER 6YO and 10YO pediatric human body models were positioned in CRSs. The 6YO was restrained on a lowback (LBB) and highback (HBB) booster, while the 10YO was positioned on an LBB and in a NoCRS condition. All simulations used the 3-point seatbelt. The child models were pre-positioned (gravity settled, seatbelt tensioned) in four naturalistic seating postures: leaning-forward, leaning-forward-inward, leaning-forward-outward, and a pre-submarining position, along with a baseline reference seating position. A 2012 Toyota Camry finite element (FE) model was used as the vehicle environment. A standard 3-point lap-shoulder belt system was modeled to restrain the child and CRS in the left-rear vehicle seat. Two vehicle impact cases were considered: with and without a pre-crash AEB. For with-AEB cases, a pre-crash phase was run to incorporate postural changes due to the application of AEB. All seating positions were ultimately subjected to a full-frontal rigid-barrier impact at 35 MPH. A total of 40 conditions were simulated in LS-DYNA.

RESULTS

Injury metrics varied widely for both occupants. Shoulder belt slippage was observed for the 6YO leaning-forward-inward on HBB. No head contact was observed for any simulated cases. Forward-leaning and forward-inward-leaning postures generally had greater head excursion across all seating postures. The lap belt rode over the pelvis for pre-submarining postures. Injury metrics for cases with pre-crash AEB were lower compared to their corresponding without-AEB cases. HIC15, head acceleration, upper neck tension force, and upper neck flexion moment were similar or lower for with-AEB scenarios.

CONCLUSIONS

Pre-crash AEB reduces the effect of the impact despite the same collision speed as cases without-AEB. This is primarily due to the limited travel distance of the occupant, thus, starting an earlier ride-down during the crash. Moreover, different initial seating postures lead to a wide range of injury exposures. Vehicle and child restraint design should incorporate these seating postures to ensure robust protection of the occupant in a crash.

Effect of automated versus manual emergency braking on rear seat adult and pediatric occupant precrash motion

Objective: Emergency braking can potentially generate precrash occupant motion that may influence the effectiveness of restraints in the subsequent crash, particularly for rear-seated occupants who may be less aware of the impending crash. With the advent of automated emergency braking (AEB), the mechanism by which braking is achieved is changing, potentially altering precrash occupant motion. Further, due to anatomical and biomechanical differences across ages, kinematic differences between AEB and manual emergency braking (MEB) may vary between child and adult occupants. Therefore, the objective of this study was to quantify differences in rear-seated adult and pediatric kinematics and muscle activity during AEB and MEB scenarios. Methods: Vehicle maneuvers were performed in a recent model year sedan traveling at 50 km/h. MEB (acceleration ∼1 g) was achieved by the driver pressing the brake pedal with maximum effort. AEB (acceleration ∼0.8 g) was triggered by the vehicle system. Inertial and Global Positioning System data were collected. Seventeen male participants aged 10-33 were restrained in the rear right passenger seat and experienced each maneuver twice. The subjects' kinematics were recorded with an 8-camera 3D motion capture system. Electromyography (EMG) recorded muscle activity. Head and trunk displacements, raw and normalized by seated height, and peak head and trunk velocity were compared across age and between maneuvers. Mean EMG was calculated to interpret kinematic findings. Results: Head and trunk displacement and peak velocity were greater in MEB than in AEB in both raw and normalized data (P ≤ .01). No effect of age was observed (P ≥ .21). Peak head and trunk velocities were greater in repetition 1 than in repetition 2 (P ≤ .006) in MEB but not in AEB. Sternocleidomastoid (SCM) mean EMG was greater in MEB compared to AEB, and muscle activity increased in repetition 2 in MEB. Conclusions: Across all ages, head and trunk excursions were greater in MEB than AEB, despite increased muscle activity in MEB. This observation may suggest an ineffective attempt to brace the head or a startle reflex. The increased excursion in MEB compared to AEB may be attributed to differences in the acceleration pulses between the 2 scenarios. These results suggest that AEB systems can use specific deceleration profiles that have potential to reduce occupant motion across diverse age groups compared to sudden maximum emergency braking applied manually.

A predictive epilepsy index based on probabilistic classification of interictal spike waveforms

Quantification of interictal spikes in EEG may provide insight on epilepsy disease burden, but manual quantification of spikes is time-consuming and subject to bias. We present a probability-based, automated method for the classification and quantification of interictal events, using EEG data from kainate- and saline-injected mice (C57BL/6J background) several weeks post-treatment. We first detected high-amplitude events, then projected event waveforms into Principal Components space and identified clusters of spike morphologies using a Gaussian Mixture Model. We calculated the odds-ratio of events from kainate- versus saline-treated mice within each cluster, converted these values to probability scores, P(kainate), and calculated an Hourly Epilepsy Index for each animal by summing the probabilities for events where the cluster P(kainate) > 0.5 and dividing the resultant sum by the record duration. This Index is predictive of whether an animal received an epileptogenic treatment (i.e., kainate), even if a seizure was never observed. We applied this method to an out-of-sample dataset to assess epileptiform spike morphologies in five kainate mice monitored for ~1 month. The magnitude of the Index increased over time in a subset of animals and revealed changes in the prevalence of epileptiform (P(kainate) > 0.5) spike morphologies. Importantly, in both data sets, animals that had electrographic seizures also had a high Index. This analysis is fast, unbiased, and provides information regarding the salience of spike morphologies for disease progression. Future refinement will allow a better understanding of the definition of interictal spikes in quantitative and unambiguous terms.

Comparison on Human Resource Requirement between Manual and Automated Dispensing Systems

OBJECTIVE

This study was conducted to compare human resource requirement among manual, automated, and modified automated dispensing systems.

METHODS

Data were collected from the pharmacy department at the 2100-bed university hospital (Siriraj Hospital, Bangkok, Thailand). Data regarding the duration of the medication distribution process were collected by using self-reported forms for 1 month. The data on the automated dispensing machine (ADM) system were obtained from 1 piloted inpatient ward, whereas those on the manual system were the average of other wards. Data on dispensing, returned unused medication, and stock management processes under the traditional manual system and the ADM system were from actual activities, whereas the modified ADM system was modeled. The full-time equivalent (FTE) of each model was estimated for comparison.

RESULTS

The result showed that the manual system required 46.84 FTEs of pharmacists and 132.66 FTEs of pharmacy technicians. By adding pharmacist roles on screening and verification under the ADM system, the ADM system required 117.61 FTEs of pharmacists. Replacing counting and filling medication functions by ADM has decreased the number of pharmacy technicians to 55.38 FTEs. After the modified ADM system canceled the return unused medication process, FTEs requirement for pharmacists and pharmacy technicians decreased to 69.78 and 51.90 FTEs, respectively.

CONCLUSIONS

The ADM system decreased the workload of pharmacy technicians, whereas it required more time from pharmacists. However, the increased workload of pharmacists was associated with more comprehensive patient care functions, which resulted from the redesigned work process.

The Effect of Incorrect Reliability Information on Expectations, Perceptions, and Use of Automation

OBJECTIVE

We examined how providing artificially high or low statements about automation reliability affected expectations, perceptions, and use of automation over time.

BACKGROUND

One common method of introducing automation is providing explicit statements about the automation's capabilities. Research is needed to understand how expectations from such introductions affect perceptions and use of automation.

METHOD

Explicit-statement introductions were manipulated to set higher-than (90%), same-as (75%), or lower-than (60%) levels of expectations in a dual-task scenario with 75% reliable automation. Two experiments were conducted to assess expectations, perceptions, compliance, reliance, and task performance over (a) 2 days and (b) 4 days.

RESULTS

The baseline assessments showed initial expectations of automation reliability matched introduced levels of expectation. For the duration of each experiment, the lower-than groups' perceptions were lower than the actual automation reliability. However, the higher-than groups' perceptions were no different from actual automation reliability after Day 1 in either study. There were few differences between groups for automation use, which generally stayed the same or increased with experience using the system.

CONCLUSION

Introductory statements describing artificially low automation reliability have a long-lasting impact on perceptions about automation performance. Statements including incorrect automation reliability do not appear to affect use of automation.

APPLICATION

Introductions should be designed according to desired outcomes for expectations, perceptions, and use of the automation. Low expectations have long-lasting effects.

Effect of automated drug distribution systems on medication error rates in a short-stay geriatric unit

RATIONALE, AIMS AND OBJECTIVES

To assess the impact of an automated drug distribution system on medication errors (MEs).

METHODS

Before-after observational study in a 40-bed short stay geriatric unit within a 1800 bed general hospital in Valenciennes, France. Researchers attended nurse medication administration rounds and compared administered to prescribed drugs, before and after the drug distribution system changed from a ward stock system (WSS) to a unit dose dispensing system (UDDS), integrating a unit dose dispensing robot and automated medication dispensing cabinet (AMDC).

RESULTS

A total of 615 opportunities of errors (OEs) were observed among 148 patients treated during the WSS period, and 783 OEs were observed among 166 patients treated during the UDDS period. ME [medication administration error (MAE)] rates were calculated and compared between the two periods. Secondary measures included type of errors, seriousness of errors and risk reduction for the patients. The implementation of an automated drug dispensing system resulted in a 53% reduction in MAEs. All error types were reduced in the UDDS period compared with the WSS period (P<0.001). Wrong dose and wrong drug errors were reduced by 79.1% (2.4% versus 0.5%, P=0.005) and 93.7% (1.9% versus 0.01%, P=0.009), respectively.

CONCLUSION

An automated UDDS combining a unit dose dispensing robot and AMDCs could reduce discrepancies between ordered and administered drugs, thus improving medication safety among the elderly.

Semi-automated and fully automated mammographic density measurement and breast cancer risk prediction

The task of breast density quantification is becoming increasingly relevant due to its association with breast cancer risk. In this work, a semi-automated and a fully automated tools to assess breast density from full-field digitized mammograms are presented. The first tool is based on a supervised interactive thresholding procedure for segmenting dense from fatty tissue and is used with a twofold goal: for assessing mammographic density (MD) in a more objective and accurate way than via visual-based methods and for labeling the mammograms that are later employed to train the fully automated tool. Although most automated methods rely on supervised approaches based on a global labeling of the mammogram, the proposed method relies on pixel-level labeling, allowing better tissue classification and density measurement on a continuous scale. The fully automated method presented combines a classification scheme based on local features and thresholding operations that improve the performance of the classifier. A dataset of 655 mammograms was used to test the concordance of both approaches in measuring MD. Three expert radiologists measured MD in each of the mammograms using the semi-automated tool (DM-Scan). It was then measured by the fully automated system and the correlation between both methods was computed. The relation between MD and breast cancer was then analyzed using a case-control dataset consisting of 230 mammograms. The Intraclass Correlation Coefficient (ICC) was used to compute reliability among raters and between techniques. The results obtained showed an average ICC=0.922 among raters when using the semi-automated tool, whilst the average correlation between the semi-automated and automated measures was ICC=0.838. In the case-control study, the results obtained showed Odds Ratios (OR) of 1.38 and 1.50 per 10% increase in MD when using the semi-automated and fully automated approaches respectively. It can therefore be concluded that the automated and semi-automated MD assessments present a good correlation. Both the methods also found an association between MD and breast cancer risk, which warrants the proposed tools for breast cancer risk prediction and clinical decision making. A full version of the DM-Scan is freely available.

Automated percutaneous lumbar discectomy for the contained herniated lumbar disc: a systematic assessment of evidence

BACKGROUND

Lumbar disc prolapse, protrusion, and extrusion account for less than 5% of all low back problems, but are the most common causes of nerve root pain and surgical interventions. The typical rationale for traditional surgery is an effort to provide more rapid relief of pain and disability. It should be noted that the majority of patients will recover with conservative management. The primary rationale for any form of surgery for disc prolapse associated with radicular pain is to relieve nerve root irritation or compression due to herniated disc material. The primary modality of treatment continues to be either open or microdiscectomy, but several alternative techniques including automated percutaneous lumbar discectomy (APLD) have been described. However, there is a paucity of evidence for all decompression techniques, specifically alternative techniques including automated and laser discectomy.

STUDY DESIGN

A systematic review of the literature.

OBJECTIVE

To determine the effectiveness of APLD.

METHODS

A comprehensive evaluation of the literature relating to automated lumbar disc decompression was performed. The literature was evaluated according to Cochrane review criteria for randomized controlled trials (RCTs), and Agency for Healthcare Research and Quality (AHRQ) criteria was utilized for observational studies. A literature search was conducted of English language literature through PubMed, EMBASE, the Cochrane library, systematic reviews, and cross references from reviews and systematic reviews. The level of evidence was classified as Level I, II, or III with 3 subcategories in Level II based on the quality of evidence developed by the United States Preventive Services Task Force (USPSTF).

OUTCOME MEASURES

Pain relief was the primary outcome measure. Other outcome measures were functional improvement, improvement of psychological status, opioid intake, and return to work. Short-term effectiveness was defined as one year or less, whereas, long-term effectiveness was defined as greater than one year.

RESULTS

Based on USPSTF criteria, the indicated evidence for APLD is Level II-2 for short- and long-term relief.

LIMITATIONS

Paucity of RCTs in the literature.

CONCLUSION

This systematic review indicated Level II-2 evidence for APLD. APLD may provide appropriate relief in properly selected patients with contained lumbar disc prolapse.

Impact of automated decision aids on performance, operator behaviour and workload in a simulated supervisory control task

In studies reporting automation effects on overall system performance and on the operator, the methods used to measure workload often did not appropriately reflect the complexity of this construct. The present study addresses the impact of automation on operator workload and behaviour in process control fault management. Workload effects were assessed with subjective, cardiovascular and secondary task performance indicators. Interactions with the interface of the process control simulation directed at gathering information and controlling the system were recorded. Automation made operators more efficient, allowing faster fault management with less information sampling and control actions. Subjective workload ratings were significantly lower in the assisted conditions as compared to manual, which was not reflected in cardiovascular and secondary task measures. Participants' information sampling activity did not differ between medium and high level of automation. Results suggest that participants paid constantly high attention to their task even with highly automated support.

The safety profile of automated collections: an analysis of more than 1 million collections

BACKGROUND

Recent technology allows for the collection of 2-unit red cells (RBCs) and single-unit RBCs plus plasma or platelets (PLTs).

STUDY DESIGN AND METHODS

With a common definition of adverse events, 1,023,682 whole-blood collections were evaluated and compared with 249,154 two-unit apheresis RBC collections, 40,870 single-apheresis RBC collections, and 90,082 apheresis PLT collections.

RESULTS

The data show that manual whole-blood collections have a low incidence of moderate and severe reactions (47.1 per 10,000 collections, 0.47%). Single-unit RBCs collected by apheresis have the same safety profile (37.44 per 10,000 collections, p > 0.20). Double-RBC collections by apheresis and plateletpheresis have a significantly lower reaction rate (15.65 per 10,000 collections, p < 0.00005; and 14.84 per 10,000 collections, p < 0.00005, respectively).

CONCLUSION

It is concluded that automated collections are safe or safer than manual whole-blood collections. There should be few concerns when procedures are performed according to manufacturer's instructions.

The Need for Command and Control Instant Message Adaptive Interfaces: Lessons Learned from Tactical Tomahawk Human-in-the-Loop Simulations

In the recent development of a human-in-the-loop simulation test bed designed to examine human performance issues for supervisory control of the Navy's new Tactical Tomahawk missile, measurements of operator situation awareness (SA) and workload through secondary tasking were taken through an embedded instant messaging program. Instant message interfaces (otherwise known as "chat"), already a means of communication between Navy ships, allow researchers to query users in real-time in a natural, ecologic setting, and thus provide more realistic and unobtrusive measurements. However, in the course of this testing, results revealed that some subjects fixated on the real-time instant messaging secondary task instead of the primary task of missile control, leading to the overall degradation of mission performance as well as a loss of SA. While this research effort was the first to quantify command and control performance degradation as a result of instant messaging, the military has recognized that in its network centric warfare quest, instant messaging is a critical informal communication tool, but has associated problems. Recently, a military spokesman said that managing chat in current military operations was sometimes a "nightmare," because military personnel have difficulty in handling large amounts of information through chat, and then synthesizing knowledge from this information. This research highlights the need for further investigation of the role of instant messaging interfaces both on task performance and situation awareness, and how the associated problems could be ameliorated through adaptive display design.

A robotics-based automated assay for inorganic and organic phosphates

Phosphate analyses are fundamental to a broad range of biochemical applications involving inorganic phosphate and organic phosphoesters such as phospholipids, phosphorylated proteins, and nucleic acids. A practical automated method utilizing robotics is described in this report. Five colorimetric methods of phosphate analyses based on formation of a phosphomolybdate complex and compatible with the automated assay were tested, and the fundamental chemistry is discussed. The relative sensitivities are malachite green > crystal violet > quinaldine red > ascorbate reduction > antimony-modified ascorbate reduction, although only a fourfold improvement was observed in going from the modified ascorbate procedure to malachite green. Malachite green was selected to optimize the assay because this dye provided the highest sensitivity. However, where color stability and low blanks are more important than sensitivity, the ascorbate reduction and quinaldine red methods were found to be better choices than malachite green. Automation using a robotic liquid-handling system substantially reduces the labor required to process large arrays of samples. The result is a sensitive, nonradioactive assay of inorganic phosphate with high throughput. A digestion step in an acid-resistant 96-well plate was developed to extend the assay to phosphate esters. The robotic-based assay was demonstrated with inorganic phosphate and a common phospholipid, phosphatidylcholine.

Medication cart-filling time, accuracy, and cost with an automated dispensing system

Medication cart filling with an automated dispensing system was compared with manual cart filling with respect to personnel time, costs, and accuracy. At a 650-bed tertiary-care medical center, technician cart filling and pharmacist cart checking were timed for the existing manual system and for the Baxter ATC-212 automated dispensing system. Subsequently, carts filled with each system were checked for accuracy of dispensing. On the basis of drugs used in the automated system over three months, drug acquisition and dispensing costs were calculated for automated and manual cart filling; the costs of personnel time were also compared. Daily cart filling time for technicians was significantly less with the automated system. The savings of pharmacist time was not significant; pharmacists had to cut the strip-packaged drugs into individual doses as they checked patients' medications. For both systems, errors were found in fewer than 1% of the doses (0.84% for the manual system and 0.65% for the automated system). Drug costs were higher with the automated system; acquisition prices for the bulk drugs purchased for use in the dispensing machine were higher than the prices of the same products in unit dose packaging. Personnel time saved amounted to less than 0.5 full-time equivalent. With the automated system, overall time savings was not great enough to substantially affect pharmacy operations, and drug costs were higher.