Dataset Information

A Review of Psychophysiological Measures to Assess Cognitive States in Real-World Driving.

ABSTRACT: As driving functions become increasingly automated, motorists run the risk of becoming cognitively removed from the driving process. Psychophysiological measures may provide added value not captured through behavioral or self-report measures alone. This paper provides a selective review of the psychophysiological measures that can be utilized to assess cognitive states in real-world driving environments. First, the importance of psychophysiological measures within the context of traffic safety is discussed. Next, the most commonly used physiology-based indices of cognitive states are considered as potential candidates relevant for driving research. These include: electroencephalography and event-related potentials, optical imaging, heart rate and heart rate variability, blood pressure, skin conductance, electromyography, thermal imaging, and pupillometry. For each of these measures, an overview is provided, followed by a discussion of the methods for measuring it in a driving context. Drawing from recent empirical driving and psychophysiology research, the relative strengths and limitations of each measure are discussed to highlight each measures' unique value. Challenges and recommendations for valid and reliable quantification from lab to (less predictable) real-world driving settings are considered. Finally, we discuss measures that may be better candidates for a near real-time assessment of motorists' cognitive states that can be utilized in applied settings outside the lab. This review synthesizes the literature on in-vehicle psychophysiological measures to advance the development of effective human-machine driving interfaces and driver support systems.

SUBMITTER: Lohani M

PROVIDER: S-EPMC6434408 | biostudies-other | 2019

REPOSITORIES: biostudies-other

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A Review of Psychophysiological Measures to Assess Cognitive States in Real-World Driving.

Lohani Monika M Payne Brennan R BR Strayer David L DL

Frontiers in human neuroscience 20190319

As driving functions become increasingly automated, motorists run the risk of becoming cognitively removed from the driving process. Psychophysiological measures may provide added value not captured through behavioral or self-report measures alone. This paper provides a selective review of the psychophysiological measures that can be utilized to assess cognitive states in real-world driving environments. First, the importance of psychophysiological measures within the context of traffic safety i ...[more]

PMID: 30941023

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Project description:BACKGROUND:The promise of real-world evidence (RWE) is especially relevant to pediatrics, where medicines prescribed for children are often used without evidence derived from randomized clinical trials. OBJECTIVES:The aim of this systematic review was to describe the state of RWE in pediatrics by identifying observational studies published during 2016 that used RWE to assess medication safety or effectiveness in children. METHODS:An electronic search of PubMed was combined with an extended search of references within systematic reviews and expert suggestions. Studies were included if they reported on an infant or child under 18 years with exposure to medications; assessed safety or effectiveness; specified a comparison or control group, and were published in English in 2016. Data extraction was conducted by one team member using a standardized form and reviewed by a second team member. Study quality was assessed using the GRACE checklist for rating the quality of observational studies. RESULTS:After removing duplicates, 915 citations were screened and 29 studies met the eligibility criteria. Most of the eligible studies relied on primary data collection or chart review at a single institution and did not use the growing number of administrative or electronic health record databases available. One-quarter of the studies did not use well-established statistical methods to control for confounders. No single disease group or medication predominated, and age groups ranged from infants to adolescents. CONCLUSIONS:A small body of observational studies published in 2016 were categorized by the study team as using real-world data to assess medication safety or effectiveness in children. Studies varied in age groups, diseases or conditions, and methods, and may not have fully met the FDA definition of RWE. Our review indicates that the use of RWE is not fully developed in pediatrics, and suggests an opportunity to further develop capabilities and more fully leverage administrative and electronic health record databases to study medication safety and effectiveness in children. Our systematic review appears generalizable to pediatrics broadly, and documents that the high level of activity in RWE in general has had less of an impact on pediatrics.

Project description:Rationale & objectiveSome US hemodialysis (HD) facilities switched from oral cinacalcet to intravenous etelcalcetide as the primary calcimimetic therapy to control parathyroid hormone (PTH) levels after the introduction of etelcalcetide in 2017. Although clinical trials have demonstrated the superior efficacy of etelcalcetide versus cinacalcet, evidence comparing real-world effectiveness is lacking.Study designProspective cohort.Setting & participantsPatients receiving HD enrolled in US Dialysis Outcomes and Practice Patterns Study facilities.ExposureWe classified HD facilities on the basis of whether >75% of calcimimetic users were prescribed etelcalcetide ("etelcalcetide-first") or cinacalcet ("cinacalcet-first") from March-August 2019.OutcomesPTH, calcium, and phosphorus levels among calcimimetic users, all averaged in the 6 months after the exposure assessment period.Analytical approachWe used adjusted linear regression to compare outcomes using 2 approaches: (1) cross-sectional comparison of etelcalcetide-first and cinacalcet-first HD facilities; (2) pre-post comparison of HD facilities that switched from cinacalcet-first to etelcalcetide-first using facilities that remained cinacalcet-first as a comparison group.ResultsWe identified 45 etelcalcetide-first and 67 cinacalcet-first HD facilities; etelcalcetide-first (vs cinacalcet-first) facilities were more likely to be from small or independent dialysis organizations (86% vs 22%) and had higher total calcimimetic use (43% vs 29%) and lower active vitamin D use (66% vs 82%). In the cross-sectional analysis comparing etelcalcetide-first and cinacalcet-first HD facilities, the adjusted mean difference in PTH levels was -115 pg/mL (95% CI, -196 to -34) and the prevalence of a PTH level of >600 pg/mL was lower (prevalence difference, -11.4%; 95% CI, -19.3% to -3.5%). Among facilities that switched to etelcalcetide-first, the mean PTH level decreased from 671 to 484 pg/mL and the prevalence of a PTH level of >600 pg/mL decreased from 39% to 21%. Among facilities that remained cinacalcet-first, the mean PTH level increased from 632 to 698 pg/mL and the prevalence of a PTH level of >600 pg/mL increased from 37% to 43%. The adjusted difference-in-difference between the switch to etelcalcetide-first and the continuation of cinacalcet-first was -169 pg/mL (-249 to -90 pg/mL) for the mean PTH and -14.4% (-22.0% to -6.8%) for a PTH level of >600 pg/mL. We also observed slightly lower serum calcium levels and minimal differences in serum phosphorus levels between the etelcalcetide-first and the cinacalcet-first facilities.LimitationsResidual confounding.ConclusionsWe observed better PTH control in HD facilities that switched from using cinacalcet to etelcalcetide as the primary calcimimetic therapy. Further research is needed to investigate how the greater real-world effectiveness of intravenous etelcalcetide (vs oral cinacalcet) may affect clinical outcomes.

Dataset Information

A Review of Psychophysiological Measures to Assess Cognitive States in Real-World Driving.

Publications

A Review of Psychophysiological Measures to Assess Cognitive States in Real-World Driving.

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