Introduction
There is a changing dynamic in research that aims to increase the participation of patients in its design and implementation. Patient and public involvement (PPI) is essential for achieving valid, clinically applicable results. A systematic review by Brett et al1 demonstrated the potential benefits of PPI in establishing and undertaking research, and writing-up and disseminating results. Eye tracking is an innovative technology used extensively in allied fields such as psychology and aerospace.2 It is increasingly used in surgical research,3 particularly assessment and training. Despite the growing popularity of the technology, there are no data investigating the patient's experience and views relating to this technology. This study aims to elicit the perception of patients' involvement in eye tracking research in order to improve their experience and the overall quality of the research.
Methods
This was a cross-sectional, qualitative study of participants concurrently involved in eye tracking research for two different ongoing clinical studies at Imperial College London. After finishing the study, participants were administered a questionnaire containing seven questions (figure 1) that used a five-point Likert scale. Additionally, an open-ended question was used to elicit further examples of how eye tracking research can be improved from a participant's point of interest.
Figure 1.
Summary of responses via a five-point Likert scale.
Results
All 26 participants (12 males, 14 females) asked to participate in this study completed the questionnaire. Figure 1 outlines the responses to the questions administered. One participant (4%) did not complete question 7 (figure 1).
In regard to patient involvement in the study, 24 participants (92%) agreed or strongly agreed with feeling comfortable participating in the concurrent study. Seventeen participants (65%) agreed or strongly agreed the research protocol takes enough account of patients' views. Fifteen patients (58%) believed participation in the study had no effect on their doctor–patient relationship.
Participants' perception of the impact of eye tracking research was overwhelmingly positive. Twenty-five participants (96%) agreed or strongly agreed that the research would be useful and 24 participants (92%) believed that eye tracking data would be useful in surgical training. In response to questions about assessing eye movements in clinical practice and intraoperatively, 17 (65%) and 20 (61%) participants, respectively, agreed or strongly agreed that these would be useful arenas in which to assess gaze metrics.
Five participants (38%) completed the open-ended question “If you are involved in future research of this nature do you have any comments about how things could be improved?”. The responses to this question were as follows:
‘I would have liked to know more about what you see on recording’.
‘Would have been nice to have this explained by the surgeon so he can assure me it's safe’.
‘It would have been nice to see the glasses before’.
‘Want to see the glasses to see if they would really impact eyesight’.
‘It would be interesting to see final results and so perhaps in the future you could take contact details’.
Discussion
It is clear that participants believe eye tracking to be a useful tool, especially for training. Data obtained via eye tracking has previously been shown to improve surgical performance via gaze training.4 5 As the beneficiaries of research it is important to assess the views of patients and continue to expand the utilisation of eye tracking research, especially considering the benefits already shown.
The evidence presented indicates that patients are happy to participate in eye tracking research, a key factor likely to be related to the non-invasive nature of the technology. Additionally, patients believe that their views are well accounted for. Resulting from the feedback in response to our open-ended question, the study protocol for future projects has been amended to allow patients to see the hardware prior to the start of the study, highlighting the importance and direct benefits of PPI.
Despite limited sample size, the study clearly identifies that patients are comfortable with participation in this type of technological research and they overwhelmingly view it as a promising research tool. In the future, this should be maintained by continuing PPI in eye tracking research and directing future work towards utilising eye tracking data in training.
Footnotes
Contributors: SE co-performed the study, contributed intellectual content, drafted the initial manuscript and reviewed, and revised the manuscript. MHS conceptualised the research question and study design, contributed intellectual content, drafted the initial manuscript and reviewed, and revised the manuscript. HA co-performed the study, contributed intellectual content and reviewed, and revised the manuscript. JD and AD contributed intellectual content and reviewed, and revised the manuscript. All the authors approved the final manuscript as submitted.
Competing interests: None declared.
Provenance and peer review: Not commissioned; internally peer reviewed.
Data sharing statement: The authors will respond to reasonable requests.
References
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