Measuring cognitively demanding activities in pediatric out-of-hospital cardiac arrest.
Measuring cognitively demanding activities in pediatric out-of-hospital cardiac arrest.
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DOI：
10.1186/s41077-023-00253-4
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发表时间：
2023-05-19
影响因子：
--
通讯作者：
Guise, Jeanne-Marie
中科院分区：
文献类型：
--
作者：
Bahr, Nathan;Ivankovic, Jonathan;Meckler, Garth;Hansen, Matthew;Eriksson, Carl;Guise, Jeanne-Marie
关键词：
这篇方法论交叉文章展示了一种在临床模拟中测量认知负荷的方法。研究人员假设，高水平的认知负荷会降低表现并增加错误。这种现象主要是通过实验设计来研究的，这些实验设计测量了对预定刺激的反应，并将经验减少到总结性值。我们的目标是开发一种方法，以确定临床活动的高认知负担，使用生理措施。从当地消防部门招募了紧急医疗响应小组，参与一个可电击的儿科院外心脏骤停（POHCA）患者的场景。该场景被标准化，患者在接受高质量CPR和3次除颤后复苏。每个团队都有一个负责人（PIC），他戴着一个功能性近红外光谱（fNIRS）设备，记录他们前额叶皮层（PFC）中氧合和脱氧血红蛋白浓度的变化，这被解释为认知活动。我们开发了一个数据处理管道来去除非神经噪声（例如，运动伪影、心率、呼吸和血压），并检测认知活动的统计学显著变化。两名研究人员独立观看视频，并对检测到的事件进行编码。通过共识解决分歧，并由临床医生验证结果。我们对122名参与者进行了18次模拟。与会者以4至7人一组的方式抵达，其中包括一名事先知情同意者。我们记录了PIC的fNIRS信号，并确定了173个与认知活动增加相关的事件。[除颤]（N = 34）、[药物]给药（N = 33）和[节律检查]（N = 28）最常与检测到的认知活动升高相一致。[除颤]与右侧PFC有亲和力，而[药物]给药和[节律检查]与左侧PFC有亲和力。FNIRS是生理学测量认知负荷的有前途的工具。我们描述了一种新的方法来扫描信号的统计上显着的事件，没有先验的假设，当他们发生。这些事件对应于关键的复苏任务，似乎是特定的任务类型的基础上激活的区域在PFC。识别和理解的临床任务，需要高认知负荷，可以建议干预措施，以减少认知负荷和护理错误的目标。
This methodological intersection article demonstrates a method to measure cognitive load in clinical simulations. Researchers have hypothesized that high levels of cognitive load reduce performance and increase errors. This phenomenon has been studied primarily by experimental designs that measure responses to predetermined stimuli and self-reports that reduce the experience to a summative value. Our goal was to develop a method to identify clinical activities with high cognitive burden using physiologic measures. Teams of emergency medical responders were recruited from local fire departments to participate in a scenario with a shockable pediatric out-of-hospital cardiac arrest (POHCA) patient. The scenario was standardized with the patient being resuscitated after receiving high-quality CPR and 3 defibrillations. Each team had a person in charge (PIC) who wore a functional near-infrared spectroscopy (fNIRS) device that recorded changes in oxygenated and deoxygenated hemoglobin concentration in their prefrontal cortex (PFC), which was interpreted as cognitive activity. We developed a data processing pipeline to remove nonneural noise (e.g., motion artifacts, heart rate, respiration, and blood pressure) and detect statistically significant changes in cognitive activity. Two researchers independently watched videos and coded clinical tasks corresponding to detected events. Disagreements were resolved through consensus, and results were validated by clinicians. We conducted 18 simulations with 122 participants. Participants arrived in teams of 4 to 7 members, including one PIC. We recorded the PIC’s fNIRS signals and identified 173 events associated with increased cognitive activity. [Defibrillation] (N = 34); [medication] dosing (N = 33); and [rhythm checks] (N = 28) coincided most frequently with detected elevations in cognitive activity. [Defibrillations] had affinity with the right PFC, while [medication] dosing and [rhythm checks] had affinity with the left PFC. FNIRS is a promising tool for physiologically measuring cognitive load. We describe a novel approach to scan the signal for statistically significant events with no a priori assumptions of when they occur. The events corresponded to key resuscitation tasks and appeared to be specific to the type of task based on activated regions in the PFC. Identifying and understanding the clinical tasks that require high cognitive load can suggest targets for interventions to decrease cognitive load and errors in care.
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影响因子：
5.3
作者：
Noah JA;Zhang X;Dravida S;DiCocco C;Suzuki T;Aslin RN;Tachtsidis I;Hirsch J
通讯作者：
Hirsch J
影响因子：
3.5
作者：
Abraham A;Pedregosa F;Eickenberg M;Gervais P;Mueller A;Kossaifi J;Gramfort A;Thirion B;Varoquaux G
通讯作者：
Varoquaux G
影响因子：
64.8
作者：
Harris CR;Millman KJ;van der Walt SJ;Gommers R;Virtanen P;Cournapeau D;Wieser E;Taylor J;Berg S;Smith NJ;Kern R;Picus M;Hoyer S;van Kerkwijk MH;Brett M;Haldane A;Del Río JF;Wiebe M;Peterson P;Gérard-Marchant P;Sheppard K;Reddy T;Weckesser W;Abbasi H;Gohlke C;Oliphant TE
通讯作者：
Oliphant TE
影响因子：
1.1
作者：
Taylor, Natasha;Wyres, Martyn;Kneafsey, Rosie
通讯作者：
Kneafsey, Rosie
影响因子：
5.7
作者：
Gagnon L;Perdue K;Greve DN;Goldenholz D;Kaskhedikar G;Boas DA
通讯作者：
Boas DA