The Holistic Processing Account of Visual Expertise in Medical Image Perception: A Review.

In the field of medical image perception, the holistic processing perspective contends that experts can rapidly extract global information about the image, which can be used to guide their subsequent search of the image (Swensson, 1980; Nodine and Kundel, 1987; Kundel et al., 2007). In this review, we discuss the empirical evidence supporting three different predictions that can be derived from the holistic processing perspective: Expertise in medical image perception is domain-specific, experts use parafoveal and/or peripheral vision to process large regions of the image in parallel, and experts benefit from a rapid initial glimpse of an image. In addition, we discuss a pivotal recent study (Litchfield and Donovan, 2016) that seems to contradict the assumption that experts benefit from a rapid initial glimpse of the image. To reconcile this finding with the existing literature, we suggest that global processing may serve multiple functions that extend beyond the initial glimpse of the image. Finally, we discuss future research directions, and we highlight the connections between the holistic processing account and similar theoretical perspectives and findings from other domains of visual expertise.

On using distributional analysis techniques for determining the onset of the influence of experimental variables.

Much of the investigation of eye-movement control in visual cognition has focused on the influence of experimental variables on mean fixation durations. In the present paper we explored the convergence between two distributional analysis techniques that were recently introduced in this domain. First, Staub, White, Drieghe, Hollway and Rayner, (2010) proposed fitting the ex-Gaussian distribution to individual participants' data in order to ascertain whether a variable has a rapid or a slow influence on fixation durations. Second, the Divergence Point Analysis (DPA) procedure was introduced by Reingold, Reichle, Glaholt and Sheridan (2012, Reingold & Sheridan, 2014) in order to determine more precisely the earliest discernible impact of a variable on the distribution of fixation durations by contrasting survival curves across two experimental conditions and determining the point at which the two curves begin to diverge. In the present paper we introduced a new version of the DPA procedure which is based on ex-Gaussian fitting. We evaluated this procedure by re-analysing data obtained in previous empirical investigations as well as by conducting a simulation study. We demonstrated that the new ex-Gaussian DPA technique produced estimates that were consistent with estimates produced by prior versions of DPA procedure, and in the present simulation, the ex-Gaussian DPA procedure produced somewhat more accurate individual participant divergence point estimates. Based on the present findings we also suggest guidelines for best practices in the use of DPA techniques.

Chess players' eye movements reveal rapid recognition of complex visual patterns: Evidence from a chess-related visual search task.

To explore the perceptual component of chess expertise, we monitored the eye movements of expert and novice chess players during a chess-related visual search task that tested anecdotal reports that a key differentiator of chess skill is the ability to visualize the complex moves of the knight piece. Specifically, chess players viewed an array of four minimized chessboards, and they rapidly searched for the target board that allowed a knight piece to reach a target square in three moves. On each trial, there was only one target board (i.e., the "Yes" board), and for the remaining "lure" boards, the knight's path was blocked on either the first move (the "Easy No" board) or the second move (i.e., "the Difficult No" board). As evidence that chess experts can rapidly differentiate complex chess-related visual patterns, the experts (but not the novices) showed longer first-fixation durations on the "Yes" board relative to the "Difficult No" board. Moreover, as hypothesized, the task strongly differentiated chess skill: Reaction times were more than four times faster for the experts relative to novices, and reaction times were correlated with within-group measures of expertise (i.e., official chess ratings, number of hours of practice). These results indicate that a key component of chess expertise is the ability to rapidly recognize complex visual patterns.

Perceptual enhancement as a result of a top-down attentional influence in a scene viewing task: Evidence from saccadic inhibition.

Prior research has shown that task instructions influence the locations and durations of eye fixations during scene viewing. These task-related changes in gaze patterns are likely to be associated with a top-down influence of attention. Presently we applied a saccadic-inhibition manipulation in order to detect another expected manifestation of top-down attention: perceptual enhancement. Participants viewed eight-item arrays containing photographs from two categories of scenes. Four of the photos depicted natural landscapes ("nature") and the other four depicted urban environments ("buildings"). Participants were instructed to memorize scenes from one of the categories in preparation for a later recognition memory test. During eye fixations the border around the fixated scene flickered briefly from black to white with a random interval between flickers ranging from 400 to 600 ms. We computed the likelihood of a saccade being initiated in the period following the flicker. Consistent with prior research, we found a strong saccadic inhibition effect with maximum saccadic inhibition occurring approximately 97 ms following the flicker. Importantly, the saccadic inhibition effect was stronger and longer lasting when the subject's eyes were fixated on a relevant scene compared to an irrelevant scene. These findings are consistent with perceptual enhancement as a result of top-down attention.

Attention and eye-movement control in reading: The selective reading paradigm.

We introduced a novel paradigm for investigating covert attention and eye-movement control in reading. In 2 experiments, participants read sentence words (shown in blue color) while ignoring interleaved distractor strings (shown in orange color). Each single-line text display contained a target word and a critical distractor. Critical distractors were located just prior to the target in the text and were either words or symbol strings (e.g., @#%&). Target word availability for parafoveal processing (i.e., preview validity) was also manipulated. The results indicated much shallower processing of distractors than targets, and this pattern was more pronounced for symbol than word distractors. The influences of word frequency and fixation location on first-pass fixation durations on distractors were dramatically different than the well-documented pattern obtained in normal reading. Robust preview benefits were demonstrated both when the critical distractors were fixated and when the critical distractors were skipped. Finally, with the exception of larger preview benefits that were obtained in the condition in which the target and critical distractor were identical, the magnitude of the preview effect was largely unaffected by the nature of the critical distractor. Implications of the present paradigm and findings to the study of eye-movement control in reading are discussed. (PsycINFO Database Record

Why does removing inter-word spaces produce reading deficits? The role of parafoveal processing.

To examine the role of inter-word spaces during reading, we used a gaze-contingent boundary paradigm to manipulate parafoveal preview (i.e., valid vs. invalid preview) in a normal text condition that contained spaces (e.g., "John decided to sell the table") and in an unsegmented text condition that contained random numbers instead of spaces (e.g.,"John4decided8to5sell9the7table"). Preview effects on mean first-fixation durations were larger for normal than unsegmented text conditions, and survival analyses revealed a delay in the onset of both preview validity and word-frequency effects on first-fixation durations for unsegmented relative to normal text. Taken together with simulations that were conducted using the E-Z Reader model, the present findings indicated that unsegmented text deficits reflect disruptions to both parafoveal processing and lexical processing. We discuss the implications of our results for models of eye-movement control.

Estimating the divergence point: a novel distributional analysis procedure for determining the onset of the influence of experimental variables.

The divergence point analysis procedure is aimed at obtaining an estimate of the onset of the influence of an experimental variable on response latencies (e.g., fixation duration, reaction time). The procedure involves generating survival curves for two conditions, and using a bootstrapping technique to estimate the timing of the earliest discernible divergence between curves. In the present paper, several key extensions for this procedure were proposed and evaluated by conducting simulations and by reanalyzing data from previous studies. Our findings indicate that the modified versions of the procedure performed substantially better than the original procedure under conditions of low experimental power. Furthermore, unlike the original procedure, the modified procedures provided divergence point estimates for individual participants and permitted testing the significance of the difference between estimates across conditions. The advantages of the modified procedures are illustrated, the theoretical and methodological implications are discussed, and promising future directions are outlined.

Expert vs. novice differences in the detection of relevant information during a chess game: evidence from eye movements.

The present study explored the ability of expert and novice chess players to rapidly distinguish between regions of a chessboard that were relevant to the best move on the board, and regions of the board that were irrelevant. Accordingly, we monitored the eye movements of expert and novice chess players, while they selected white's best move for a variety of chess problems. To manipulate relevancy, we constructed two different versions of each chess problem in the experiment, and we counterbalanced these versions across participants. These two versions of each problem were identical except that a single piece was changed from a bishop to a knight. This subtle change reversed the relevancy map of the board, such that regions that were relevant in one version of the board were now irrelevant (and vice versa). Using this paradigm, we demonstrated that both the experts and novices spent more time fixating the relevant relative to the irrelevant regions of the board. However, the experts were faster at detecting relevant information than the novices, as shown by the finding that experts (but not novices) were able to distinguish between relevant and irrelevant information during the early part of the trial. These findings further demonstrate the domain-related perceptual processing advantage of chess experts, using an experimental paradigm that allowed us to manipulate relevancy under tightly controlled conditions.

The Einstellung effect in anagram problem solving: evidence from eye movements.

The Einstellung effect is the counterintuitive finding that prior experience or domain-specific knowledge can under some circumstances interfere with problem solving performance. This effect has been demonstrated in several domains of expertise including medicine and chess. In the present study we explored this effect in the context of a simplified anagram problem solving task. Participants solved anagram problems while their eye movements were monitored. Each problem consisted of six letters: a central three-letter string whose letters were part of the solution word, and three additional individual letters. Participants were informed that one of the individual letters was a distractor letter and were asked to find a five-letter solution word. In order to examine the impact of stimulus familiarity on problem solving performance and eye movements, the central letter string was presented either as a familiar three-letter word, or the letters were rearranged to form a three-letter nonword. Replicating the classic Einstellung effect, overall performance was better for nonword than word trials. However, participants' eye movements revealed a more complex pattern of both interference and facilitation as a function of the familiarity of the central letter string. Specifically, word trials resulted in shorter viewing times on the central letter string and longer viewing times on the individual letters than nonword trials. These findings suggest that while participants were better able to encode and maintain the meaningful word stimuli in working memory, they found it more challenging to integrate the individual letters into the central letter string when it was presented as a word.

Eye Tracking Research and Technology: Towards Objective Measurement of Data Quality.

Two methods for objectively measuring eye tracking data quality are explored. The first method works by tricking the eye tracker to detect an abrupt change in the gaze position of an artificial eye that in actuality does not move. Such a device, referred to as an artificial saccade generator, is shown to be extremely useful for measuring the temporal accuracy and precision of eye tracking systems and for validating the latency to display change in gaze contingent display paradigms. The second method involves an artificial pupil that is mounted on a computer controlled moving platform. This device is designed to be able to provide the eye tracker with motion sequences that closely resemble biological eye movements. The main advantage of using artificial motion for testing eye tracking data quality is the fact that the spatiotemporal signal is fully specified in a manner independent of the eye tracker that is being evaluated and that nearly identical motion sequence can be reproduced multiple times with great precision. The results of the present study demonstrate that the equipment described has the potential to become an important tool in the comprehensive evaluation of data quality.

The mechanisms and boundary conditions of the Einstellung effect in chess: evidence from eye movements.

In a wide range of problem-solving settings, the presence of a familiar solution can block the discovery of better solutions (i.e., the Einstellung effect). To investigate this effect, we monitored the eye movements of expert and novice chess players while they solved chess problems that contained a familiar move (i.e., the Einstellung move), as well as an optimal move that was located in a different region of the board. When the Einstellung move was an advantageous (but suboptimal) move, both the expert and novice chess players who chose the Einstellung move continued to look at this move throughout the trial, whereas the subset of expert players who chose the optimal move were able to gradually disengage their attention from the Einstellung move. However, when the Einstellung move was a blunder, all of the experts and the majority of the novices were able to avoid selecting the Einstellung move, and both the experts and novices gradually disengaged their attention from the Einstellung move. These findings shed light on the boundary conditions of the Einstellung effect, and provide convergent evidence for Bilalic, McLeod, & Gobet (2008)'s conclusion that the Einstellung effect operates by biasing attention towards problem features that are associated with the familiar solution rather than the optimal solution.

Spatial frequency filtering and the direct control of fixation durations during scene viewing.

The present study employed a saccade-contingent change paradigm to investigate the effect of spatial frequency filtering on fixation durations during scene viewing. Subjects viewed grayscale scenes while encoding them for a later memory test. During randomly chosen saccades, the scene was replaced with an alternate version that remained throughout the critical fixation that followed. In Experiment 1, during the critical fixation, the scene could be changed to high-pass and low-pass spatial frequency filtered versions. Under both conditions, fixation durations increased, and the low-pass condition produced a greater effect than the high-pass condition. In subsequent experiments, we manipulated the familiarity of scene information during the critical fixation by flipping the filtered scenes upside down or horizontally. Under these conditions, we observed lengthening of fixation durations but no difference between the high-pass and low-pass conditions, suggesting that the filtering effect is related to the mismatch between information extracted within the critical fixation and the ongoing scene representation in memory. We also conducted control experiments that tested the effect of changes to scene orientation (Experiment 2a) and the addition of color to a grayscale scene (Experiment 2b). Fixation distribution analysis suggested two effects on the distribution fixation durations: a fast-acting effect that was sensitive to all transsaccadic changes tested and a later effect in the tail of the distribution that was likely tied to the processing of scene information. These findings are discussed in the context of theories of oculomotor control during scene viewing.

Neurophysiological constraints on the eye-mind link.

Several current computational models of eye-movement control in reading posit a tight link between the eye and mind, with lexical processing directly triggering most "decisions" about when to start programming a saccade to move the eyes from one word to the next. One potential problem with this theoretical assumption, however, is that it may violate neurophysiological constraints imposed by the time required to encode visual information, complete some amount of lexical processing, and then program a saccade. In this article, we review what has been learned about these timing constraints from studies using ERP and MEG. On the basis of this review, it would appear that the temporal constraints are too severe to permit direct lexical control of eye movements without a significant amount of parafoveal processing (i.e., pre-processing of word n+1 from word n). This conclusion underscores the degree to which the perceptual, cognitive, and motor processes involved in reading must be highly coordinated to support skilled reading, a par excellence example of a task requiring visual-cognitive expertise.

A further examination of the lexical-processing stages hypothesized by the E-Z Reader model.

Participants' eye movements were monitored while they read sentences in which high- and low-frequency target words were presented normally (i.e., the normal condition) or with either reduced stimulus quality (i.e., the faint condition) or alternating lower- and uppercase letters (i.e., the case-alternated condition). Both the stimulus quality and case alternation manipulations interacted with word frequency for the gaze duration measure, such that the magnitude of word frequency effects was increased relative to the normal condition. However, stimulus quality (but not case alternation) interacted with word frequency for the early fixation time measures (i.e., first fixation, single fixation), whereas case alternation (but not stimulus quality) interacted with word frequency for the later fixation time measures (i.e., total time, go-past time). We interpret this pattern of results as evidence that stimulus quality influences an earlier stage of lexical processing than does case alternation, and we discuss the implications of our results for models of eye movement control during reading.

Perceptually specific and perceptually non-specific influences on rereading benefits for spatially transformed text: evidence from eye movements.

The present study used eye tracking methodology to examine rereading benefits for spatially transformed text. Eye movements were monitored while participants read the same target word twice, in two different low-constraint sentence frames. The congruency of perceptual processing was manipulated by either applying the same type of transformation to the word during the first and second presentations (i.e., the congruent condition), or employing two different types of transformations across the two presentations of the word (i.e., the incongruent condition). Perceptual specificity effects were demonstrated such that fixation times for the second presentation of the target word were shorter for the congruent condition compared to the incongruent condition. Moreover, we demonstrated an additional perceptually non-specific effect such that second reading fixation times were shorter for the incongruent condition relative to a baseline condition that employed a normal typography (i.e., non-transformed) during the first presentation and a transformation during the second presentation. Both of these effects (i.e., perceptually specific and perceptually non-specific) were similar in magnitude for high and low frequency words, and both effects persisted across a 1 week lag between the first and second readings. We discuss the present findings in the context of the distinction between conscious and unconscious memory, and the distinction between perceptually versus conceptually driven processing.

Direct lexical control of eye movements in reading: evidence from a survival analysis of fixation durations.

Participants' eye movements were monitored in an experiment that manipulated the frequency of target words (high vs. low) as well as their availability for parafoveal processing during fixations on the pre-target word (valid vs. invalid preview). The influence of the word-frequency by preview validity manipulation on the distributions of first fixation duration was examined by using ex-Gaussian fitting as well as a novel survival analysis technique which provided precise estimates of the timing of the first discernible influence of word frequency on first fixation duration. Using this technique, we found a significant influence of word frequency on fixation duration in normal reading (valid preview) as early as 145ms from the start of fixation. We also demonstrated an equally rapid non-lexical influence on first fixation duration as a function of initial landing position (location) on target words. The time-course of frequency effects, but not location effects was strongly influenced by preview validity, demonstrating the crucial role of parafoveal processing in enabling direct lexical control of reading fixation times. Implications for models of eye-movement control are discussed.

The time course of contextual influences during lexical ambiguity resolution: evidence from distributional analyses of fixation durations.

In the lexical ambiguity literature, it is well-established that readers experience processing difficulties when they encounter biased homographs in a subordinate-instantiating prior context (i.e., the subordinate bias effect). To investigate the time course of this effect, the present study examined distributional analyses of first-fixation durations on 60 biased homographs that were each read twice: once in a subordinate-instantiating context and once in a dominant-instantiating context. Ex-Gaussian fitting revealed that the subordinate context distribution was shifted to the right of the dominant context distribution, with no significant contextual differences in the degree of skew. In addition, a survival analysis technique showed a significant influence of the subordinate versus dominant contextual manipulation as early as 139 ms from the start of fixation. These results indicate that the contextual manipulation had a fast-acting influence on the majority of fixation durations, which is consistent with the reordered access model's assumption that prior context can affect the lexical access stage of reading.

The mask-onset delay paradigm and the availability of central and peripheral visual information during scene viewing.

We employed a variant of the mask-onset delay paradigm in order to limit the availability of visual information in central and peripheral vision within individual fixations during scene viewing. Subjects viewed full-color scene photos with instructions to search for a target object (Experiment 1) or to study them for a later memory test (Experiment 2). After a fixed interval following the onset of each eye fixation (50-100 ms), the scene was scrambled either in the central visual field or over the entire display. The intact scene was presented when the subject made an eye movement. Our results reconcile different sets of findings from prior research regarding the masking of central and peripheral visual information at different intervals following fixation onset. In particular, we found that when the entire display was scrambled, both search and memory performance were impaired even at relatively long mask-onset intervals. In contrast, when central vision was scrambled, there were subtle impairments that depended on the viewing task. In the 50-ms mask-onset interval, subjects were selectively impaired at identifying, but not in locating, the search target (Experiment 1), while memory performance (Experiment 2) was unaffected in this condition, and hence, the reliance on central and peripheral visual information depends partly on the viewing task.

Levels of processing influences both recollection and familiarity: evidence from a modified remember-know paradigm.

A modified Remember/Know (RK) paradigm was used to investigate reported subjective awareness during retrieval. Levels of processing (shallow vs. deep) was manipulated at study. Word pairs (old/new or new/new) were presented during test trials, and participants were instructed to respond "remember" if they recollected one of the two words, "know" if the word was familiar in the absence of recollection, or "new" if they judged both words to be new. Participants were then required to indicate which of the 2 words was old (2AFC recognition). With the standard RK proportions, deeper processing at study increased remember proportions and decreased know proportions, but this dissociation was not shown with the 2AFC proportion correct measure which instead demonstrated robust LOP effects for both remember and know trials, suggesting that the know proportion measure severely distorts the nature of LOP effects on familiarity.

Controlling the spotlight of attention: visual span size and flexibility in schizophrenia.

The current study investigated the size and flexible control of visual span among patients with schizophrenia during visual search performance. Visual span is the region of the visual field from which one extracts information during a single eye fixation, and a larger visual span size is linked to more efficient search performance. Therefore, a reduced visual span may explain patients' impaired performance on search tasks. The gaze-contingent moving window paradigm was used to estimate the visual span size of patients and healthy participants while they performed two different search tasks. In addition, changes in visual span size were measured as a function of two manipulations of task difficulty: target-distractor similarity and stimulus familiarity. Patients with schizophrenia searched more slowly across both tasks and conditions. Patients also demonstrated smaller visual span sizes on the easier search condition in each task. Moreover, healthy controls' visual span size increased as target discriminability or distractor familiarity increased. This modulation of visual span size, however, was reduced or not observed among patients. The implications of the present findings, with regard to previously reported visual search deficits, and other functional and structural abnormalities associated with schizophrenia, are discussed.