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. 2023 Dec;32(12):3557-3569.
doi: 10.1007/s11136-023-03488-w. Epub 2023 Jul 20.

Feasibility of self-reported health related quality of life assessment with older people in residential care: insights from the application of eye tracking technology

Rachel Milte  1 , Matthew Crocker  2 , Kiri Lay  2 , Julie Ratcliffe  2 , Brendan Mulhern  3 , Richard Norman  4 , Rosalie Viney  3 , Jyoti Khadka  2
Affiliations

Feasibility of self-reported health related quality of life assessment with older people in residential care: insights from the application of eye tracking technology

Rachel Milte et al. Qual Life Res. 2023 Dec.

Abstract

Purpose: Increasingly there are calls to routinely assess the health-related quality of life (HRQoL) of older people receiving aged care services, however the high prevalence of dementia and cognitive impairment remains a challenge to implementation. Eye-tracking technology facilitates detailed assessment of engagement and comprehension of visual stimuli, and may be useful in flagging individuals and populations who cannot reliably self-complete HRQoL instruments. The aim of this study was to apply eye-tracking technology to provide insights into self-reporting of HRQoL among older people in residential care with and without cognitive impairment.

Methods: Residents (n = 41), recruited based on one of three cognition subgroups (no, mild, or moderate cognitive impairment), completed the EQ-5D-5L on a computer with eye tracking technology embedded. Number and length of fixations (i.e., eye gaze in seconds) for key components of the EQ-5D-5L descriptive system were calculated.

Results: For all dimensions, participants with no cognitive impairment fixated for longer on the Area of Interest (AOI) for the response option they finally chose, relative to those with mild or moderate cognitive impairment. Participants with cognitive impairment followed similar fixation patterns to those without. There was some evidence that participants with cognitive impairment took longer to complete and spent relatively less time attending to the relevant AOIs, but these differences did not reach statistical significance generally.

Conclusions: This exploratory study applying eye tracking technology provides novel insights and evidence of the feasibility of self-reported HRQoL assessments in older people in aged care settings where cognitive impairment and dementia are highly prevalent.

Keywords: Cognitive impairment; EQ-5D-5L; Eye-tracking; Feasibility; Older adult; Quality of life.

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Conflict of interest statement

RN, RV, and BM are members of and hold existing research funding from the EuroQol Group. The contents of this study do not necessarily reflect the view of the EuroQol Group.

Figures

Fig. 1
Fig. 1
Example relevant areas of interest
Fig. 2
Fig. 2
Agreement between time spent focusing on dimension levels and dimension level finally selected. A difference of 4 points between reponse fixated upon and the response chosen is only possible for the highest or lowest possible dimenion levels. For other responses, lower proportions of disagrement (e.g. 3, 2, 1) only be possible. Please note that the figure above presents this data in raw form, and it is not adjusted for whether the level of agreement is possible given the response option chosen by the participant
See this image and copyright information in PMC

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