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Tonic exploration governs both flexibility and lapses.

ABSTRACT: In many cognitive tasks, lapses (spontaneous errors) are tacitly dismissed as the result of nuisance processes like sensorimotor noise, fatigue, or disengagement. However, some lapses could also be caused by exploratory noise: randomness in behavior that facilitates learning in changing environments. If so, then strategic processes would need only up-regulate (rather than generate) exploration to adapt to a changing environment. This view predicts that more frequent lapses should be associated with greater flexibility because these behaviors share a common cause. Here, we report that when rhesus macaques performed a set-shifting task, lapse rates were negatively correlated with perseverative error frequency across sessions, consistent with a common basis in exploration. The results could not be explained by local failures to learn. Furthermore, chronic exposure to cocaine, which is known to impair cognitive flexibility, did increase perseverative errors, but, surprisingly, also improved overall set-shifting task performance by reducing lapse rates. We reconcile these results with a state-switching model in which cocaine decreases exploration by deepening attractor basins corresponding to rule states. These results support the idea that exploratory noise contributes to lapses, affecting rule-based decision-making even when it has no strategic value, and suggest that one key mechanism for regulating exploration may be the depth of rule states.

SUBMITTER: Ebitz RB

PROVIDER: S-EPMC6867658 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Tonic exploration governs both flexibility and lapses.

Ebitz R Becket RB Sleezer Brianna J BJ Jedema Hank P HP Bradberry Charles W CW Hayden Benjamin Y BY

PLoS computational biology 20191108 11

In many cognitive tasks, lapses (spontaneous errors) are tacitly dismissed as the result of nuisance processes like sensorimotor noise, fatigue, or disengagement. However, some lapses could also be caused by exploratory noise: randomness in behavior that facilitates learning in changing environments. If so, then strategic processes would need only up-regulate (rather than generate) exploration to adapt to a changing environment. This view predicts that more frequent lapses should be associated w ...[more]

PMID: 31703063

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Project description:Objective To develop a novel methodology to identify lapses in diabetic retinopathy care in electronic health records (EHRs) and evaluate health disparities by race and ethnicity. Design Retrospective cohort study. Subjects Adult patients with diabetes mellitus who were evaluated at the Wilmer Eye Institute from January 1, 2013 to April 2, 2022. Methods The methodology to identify lapses in care first identified diabetic retinopathy screening or treatment visits and then compared the providers’ recommended follow-up timeframe with the patient’s actual time to next encounter. The association of race and ethnicity with odds of lapses in care was evaluated using a mixed-effects logistic regression model controlling for age, sex, insurance, severity of diabetic retinopathy, presence of other retinal disorders, and glaucoma. Main Outcome Measures Lapses in diabetic retinopathy care. Results The methodology to identify diabetic retinopathy-related visits had a 95.0% (95% confidence interval, 93.0–96.6) sensitivity and 98.8% (98.1–99.3) specificity as compared with a gold standard grader. The methodology resulted in a 97.3% (96.2–98.4) sensitivity and 98.1% (97.3–98.9) specificity for detecting a follow-up recommendation, with an average error of −0.05 (−0.31 to 0.21) weeks in extracting the precise timeframe. A total of 39 561 patients with 91 104 office visits were included in the analysis. The average age was 61.4 years. More than 3 (77.6%) in 4 patients had a lapse in care. In multivariable analysis, non-Hispanic Black patients had 1.24 (1.19–1.30) odds and Hispanic patients had 1.26 (1.13–1.40) odds of ever having a lapse in care compared with non-Hispanic White patients (P < 0.001, respectively). Conclusions We have developed a reliable methodology for identifying lapses in diabetic retinopathy care that is tailored to a provider’s recommended follow-up. Using this approach, we find that 3 in 4 patients experience a lapse in diabetic retinopathy care and that these rates are higher among non-Hispanic Black and Hispanic patients. Deploying this methodology in the EHR is one potential means by which to identify and mitigate lapses in critical ophthalmic care in patients with diabetes. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.

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Tonic exploration governs both flexibility and lapses.

Publications

Tonic exploration governs both flexibility and lapses.

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