Interrater reliability in pupillary assessment among intensive care nurses. Kebapcı Ayda,Topçu Serpil Intensive & critical care nursing BACKGROUND:Pupillary abnormalities are a common and reliable finding of brain herniation, ischaemia, and acute brain injury in critically ill patients. Reliable pupil assessment is a vital evaluation in diagnostic and therapeutic procedures for neurocritical patients. AIM:To evaluate inter-rater reliability of pupillary assessment among intensive care. METHODS:In this prospective, blind observational study, intensive care nurses and two researchers evaluated the pupil size, reactivity and symmetry of 200 patients with neurosurgery or neurological diseases. A total of 200 pupillary measurement sets were completed independently and blindly. RESULTS:Three observers -two researchers and the nurse- found fair-to-good and excellent agreements in initial pupil size evaluations of right and left pupils, respectively (ICC = 0.70, 95%; ICC = 0.75, 95%). In patients with pupil size ≥4 mm, the observers found fair-to-good agreements in both right and left pupil initial size measurements (ICC = 0.52; ICC = 0.65). Agreement in pupil symmetry was moderated (K = 0.58), and reactivity was near perfect (K = 0.89) between the three observers. CONCLUSION:Although the two researchers found near perfect agreement in pupil size, symmetry and reactivity assessment, two researchers and the nurse found moderate agreement in pupil symmetry and fair-to-good agreement in pre- and post-light stimulation pupil size. 10.1016/j.iccn.2020.102801

Preprocessing pupil size data: Guidelines and code. Kret Mariska E,Sjak-Shie Elio E Behavior research methods Pupillometry has been one of the most widely used response systems in psychophysiology. Changes in pupil size can reflect diverse cognitive and emotional states, ranging from arousal, interest and effort to social decisions, but they are also widely used in clinical practice to assess patients' brain functioning. As a result, research involving pupil size measurements has been reported in practically all psychology, psychiatry, and psychophysiological research journals, and now it has found its way into the primatology literature as well as into more practical applications, such as using pupil size as a measure of fatigue or a safety index during driving. The different systems used for recording pupil size are almost as variable as its applications, and all yield, as with many measurement techniques, a substantial amount of noise in addition to the real pupillometry data. Before analyzing pupil size, it is therefore of crucial importance first to detect this noise and deal with it appropriately, even prior to (if need be) resampling and baseline-correcting the data. In this article we first provide a short review of the literature on pupil size measurements, then we highlight the most important sources of noise and show how these can be detected. Finally, we provide step-by-step guidelines that will help those interested in pupil size to preprocess their data correctly. These guidelines are accompanied by an open source MATLAB script (available at https://github.com/ElioS-S/pupil-size ). Given that pupil diameter is easily measured by standard eyetracking technologies and can provide fundamental insights into cognitive and emotional processes, it is hoped that this article will further motivate scholars from different disciplines to study pupil size. 10.3758/s13428-018-1075-y

Arousal-based pupil modulation is dictated by luminance. Scientific reports Pupillometry has become a standard measure for assessing arousal state. However, environmental factors such as luminance, a primary dictator of pupillary responses, often vary across studies. To what degree does luminance interact with arousal-driven pupillary changes? Here, we parametrically assessed luminance-driven pupillary responses across a wide-range of luminances, while concurrently manipulating cognitive arousal using auditory math problems of varying difficulty. At the group-level, our results revealed that the modulatory effect of cognitive arousal on pupil size interacts multiplicatively with luminance, with the largest effects occurring at low and mid-luminances. However, at the level of individuals, there were qualitatively distinct individual differences in the modulatory effect of cognitive arousal on luminance-driven pupillary responses. Our findings suggest that pupillometry as a measure for assessing arousal requires more careful consideration: there are ranges of luminance levels that are more ideal in observing pupillary differences between arousal conditions than others. 10.1038/s41598-022-05280-1

The effect evaluation of advanced penlight. Chiou Piao-Yi,Chien Chih-Yin,Lai Yi-Horng,Chun Chang Feng PloS one Pupil diameter measurement is crucial for physical assessment and disease monitoring in a health and nursing care situation. A general penlights (GPLs) is frequently used and allow for an approximate and indirect measurement of the pupil diameter. Health caregivers or nurses generally have less confidence in the value of the pupil diameter measured using the GPL. The Advanced Penlight (APL) is a new device designed for accurate measurement of the pupil diameter. The purpose of the presented research was to compare the accuracies and operational times of the pupil diameter measurements by means of the GPL and APL. One-group post-test and single-blind study designed was used in this study. The innovation of the APL is the addition of a perspective measurement ruler (PMR) attached to one side of the penlight that allows precise measurement of the pupil diameter before and after pupillary contraction. The PMR can be rotated by any angle for adaptation to the measurement conditions. After standard pupil diameter measurements by a refractometer (RM) were performed on a subjects, ninety study participants measured the pupil diameters of the same subject separately by the GPL and APL. A self-administered questionnaire was used to assess the opinions of the participants after using the GPL compare to the APL. The mean age of the participants was 20.01 (SD = 0.47) years and 83% of them were female senior nursing students. There were no statistically significant differences between the average values of pupil diameters measured by the APL and the RM. Compared to the GPL, the pupil diameter measured by APL was much similar to the RM measurement. The average operational time was 8.72 seconds shorter (t = -3.81, p = 0.001) for the APL measurement compared to the GPL measurement. The average scores of convenience and confidence on pupil diameter measurements of questionnaire were higher for the APL compared to the GPL. The APL can increase the accuracy and save operating time of pupil diameter measurement and thereby promote the quality of health assessment and nursing care practice. 10.1371/journal.pone.0205978