Response tendencies due to item wording using eye-tracking methodology accounting for individual differences and item characteristics

The discrepancy of the scores on responses to negatively and positively worded items has led to hypotheses of inattention, confusion, difficulty, and differential processing of negatively worded items. The present study, utilizing eye-tracking methodology, aimed to fill an explanatory gap regarding response behavior, providing observations on the item-level response process. It experimentally examined characteristics of the items (wording type, self-relevance) and characteristics of the respondents (neuroticism, verbal abilities, and mood) for their impact on response outcomes. A sample of 87 university students completed a computerized version of a questionnaire with items presented in four alternative wording types: positive, negative, negated positive, and negated negative; half of the items referred to attitudes toward the self and the other half to attitudes toward others. Participants' eye movements during item completion were recorded with the Gazepoint-GP3-HD desk-mounted eye tracker. In linear mixed effects models, wording type and self-relevance were found to relate to response time, time of viewing and revisits to the body of the items and the response options, indicating that there were effects at the stages of comprehension and selection of response. Neuroticism was associated with differential item responses, suggesting a role in later levels of the response process, the retrieval, judgment, and response selection stages. Eye-tracking measures can enhance the examination of response tendencies with regards to item content, item wording, and person characteristics.

Very preterm infants engage in an intervention to train their control of attention: results from the feasibility study of the Attention Control Training (ACT) randomised trial

Background

Very premature birth (gestational age between 28 and 31 + 6 weeks) is associated with increased risk of cognitive delay and attention deficit disorder, which have been linked to anomalies in the development of executive functions (EFs) and their precursors. In particular, very preterm (VP) infants display anomalies in controlling attention and gathering task-relevant information. Early interventions that support attention control may be pivotal in providing a secure base for VP children’s later attainments. The Attention Control Training (ACT) is a cognitive training intervention that targets infants’ abilities to select visual information according to varying task demands but had not been tested in VP infants. We conducted a feasibility study to test the processes we intend to use in a trial delivering the ACT to VP infants.

Methods and design

We tested recruitment and retention of VP infants and their families in a randomised trial, as well as acceptability and completion of baseline and outcome measures. To evaluate these aims, we used descriptive quantitative statistics and qualitative methods to analyse feedback from infants’ caregivers. We also investigated the quality of eye-tracking data collected and indicators of infants’ engagement in the training, using descriptive statistics.

Results

Twelve VP infants were recruited, and 10 (83%) completed the study. Participants’ parents had high education attainment. The rate of completion of baseline and outcome measures was optimal. VP infants demonstrated engagement in the training, completing on average 84 min of training over three visits, and displaying improved performance during this training. Eye-tracking data quality was moderate, but this did not interfere with infants’ engagement in the training.

Discussion

The results suggest the ACT can be delivered to VP infants. However, challenges remain in recruitment of numerous and diverse samples. We discuss strategies to overcome these challenges informed by results of this study.

Trial registration

Registered Registration ID: NCT03896490. Retrospectively registered at Clinical Trials Protocol Registration and Results System (clinicaltrials.gov).

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-021-00809-z.

Training attention control of very preterm infants: protocol for a feasibility study of the Attention Control Training (ACT)

BACKGROUND

Children born preterm may display cognitive, learning, and behaviour difficulties as they grow up. In particular, very premature birth (gestation age between 28 and less than 32 weeks) may put infants at increased risk of intellectual deficits and attention deficit disorder. Evidence suggests that the basis of these problems may lie in difficulties in the development of executive functions. One of the earliest executive functions to emerge around 1 year of age is the ability to control attention. An eye-tracking-based cognitive training programme to support this emerging ability, the Attention Control Training (ACT), has been developed and tested with typically developing infants. The aim of this study is to investigate the feasibility of using the ACT with healthy very preterm (VP) infants when they are 12 months of age (corrected age). The ACT has the potential to address the need for supporting emerging cognitive abilities of VP infants with an early intervention, which may capitalise on infants' neural plasticity.

METHODS/DESIGN

The feasibility study is designed to investigate whether it is possible to recruit and retain VP infants and their families in a randomised trial that compares attention and social attention of trained infants against those that are exposed to a control procedure. Feasibility issues include the referral/recruitment pathway, attendance, and engagement with testing and training sessions, completion of tasks, retention in the study, acceptability of outcome measures, quality of data collected (particularly, eye-tracking data). The results of the study will inform the development of a larger randomised trial.

DISCUSSION

Several lines of evidence emphasise the need to support emerging cognitive and learning abilities of preterm infants using early interventions. However, early interventions with preterm infants, and particularly very preterm ones, face difficulties in recruiting and retaining participants. These problems are also augmented by the health vulnerability of this population. This feasibility study will provide the basis for informing the implementation of an early cognitive intervention for very preterm infants.

TRIAL REGISTRATION

Registered Registration ID: NCT03896490. Retrospectively registered at Clinical Trials Protocol Registration and Results System (clinicaltrials.gov).

Reversal of the hanging protocol of Contrast Enhanced Mammography leads to similar diagnostic performance yet decreased reading times

OBJECTIVES

Contrast-enhanced mammography (CEM) was found superior to Full-Field Digital Mammography (FFDM) for breast cancer detection. Current hanging protocols show low-energy (LE, similar to FFDM) images first, followed by recombined (RC) images. However, evidence regarding which hanging protocol leads to the most efficient reading process and highest diagnostic performance is lacking. This study investigates the effects of hanging-protocol ordering on the reading process and diagnostic performance of breast radiologists using eye-tracking methodology. Furthermore, it investigates differences in reading processes and diagnostic performance between LE, RC and FFDM images.

MATERIALS AND METHODS

Twenty-seven breast radiologists were randomized into three reading groups: LE-RC (commonly used hangings), RC-LE (reversed hangings) and FFDM. Thirty cases (nine malignant) were used. Fixation count, net dwell time and time-to-first fixation on malignancies as visual search measures were registered by the eye-tracker. Reading time per image was measured. Participants clicked on suspicious lesions to determine sensitivity and specificity. Area-under-the-ROC-curve (AUC) values were calculated.

RESULTS

RC-LE scored identical on visual search measures, t(16)= -1.45, p =  .17 or higher-p values, decreased reading time with 31%, t(16)= -2.20, p = .04, while scoring similar diagnostic performance compared to LE-RC, t(13.2) = -1.39, p - .20 or higher p-values. The reading process was more efficient on RC compared to LE. Diagnostic performance of CEM was superior to FFDM; F (2,26) = 16.1, p <  .001. Average reading time did not differ between the three groups, F (2,25) = 3.15, p =  .06.

CONCLUSION

The reversed CEM hanging protocol (RC-LE) scored similar on diagnostic performance compared to LE-RC, while reading time was a third faster. Abnormalities were interpreted quicker on RC images. A RC-LE hanging protocol is therefore recommended for clinical practice and training. Diagnostic performance of CEM was (again) superior to FFDM.

Gazepath: An eye-tracking analysis tool that accounts for individual differences and data quality

Eye-trackers are a popular tool for studying cognitive, emotional, and attentional processes in different populations (e.g., clinical and typically developing) and participants of all ages, ranging from infants to the elderly. This broad range of processes and populations implies that there are many inter- and intra-individual differences that need to be taken into account when analyzing eye-tracking data. Standard parsing algorithms supplied by the eye-tracker manufacturers are typically optimized for adults and do not account for these individual differences. This paper presents gazepath, an easy-to-use R-package that comes with a graphical user interface (GUI) implemented in Shiny (RStudio Inc 2015). The gazepath R-package combines solutions from the adult and infant literature to provide an eye-tracking parsing method that accounts for individual differences and differences in data quality. We illustrate the usefulness of gazepath with three examples of different data sets. The first example shows how gazepath performs on free-viewing data of infants and adults, compared to standard EyeLink parsing. We show that gazepath controls for spurious correlations between fixation durations and data quality in infant data. The second example shows that gazepath performs well in high-quality reading data of adults. The third and last example shows that gazepath can also be used on noisy infant data collected with a Tobii eye-tracker and low (60 Hz) sampling rate.