Inattentional blindness in medicine.

People often fail to notice unexpected stimuli when their attention is directed elsewhere. Most studies of this "inattentional blindness" have been conducted using laboratory tasks with little connection to real-world performance. Medical case reports document examples of missed findings in radiographs and CT images, unintentionally retained guidewires following surgery, and additional conditions being overlooked after making initial diagnoses. These cases suggest that inattentional blindness might contribute to medical errors, but relatively few studies have directly examined inattentional blindness in realistic medical contexts. We review the existing literature, much of which focuses on the use of augmented reality aids or inspection of medical images. Although these studies suggest a role for inattentional blindness in errors, most of the studies do not provide clear evidence that these errors result from inattentional blindness as opposed to other mechanisms. We discuss the design, analysis, and reporting practices that can make the contributions of inattentional blindness unclear, and we describe guidelines for future research in medicine and similar contexts that could provide clearer evidence for the role of inattentional blindness.

Are Familiar Objects More Likely to Be Noticed in an Inattentional Blindness Task?

People often fail to notice the presence of unexpected objects when their attention is engaged elsewhere. In dichotic listening tasks, for example, people often fail to notice unexpected content in the ignored speech stream even though they occasionally do notice highly familiar stimuli like their own name (the "cocktail party" effect). Some of the first studies of inattentional blindness were designed as a visual analog of such dichotic listening studies, but relatively few inattentional blindness studies have examined how familiarity affects noticing. We conducted four preregistered inattentional blindness experiments (total N = 1700) to examine whether people are more likely to notice a familiar unexpected object than an unfamiliar one. Experiment 1 replicated evidence for greater noticing of upright schematic faces than inverted or scrambled ones. Experiments 2-4 tested whether participants from different pairs of countries would be more likely to notice their own nation's flag or petrol company logo than those of another country. These experiments repeatedly found little or no evidence that familiarity affects noticing rates for unexpected objects. Frequently encountered and highly familiar stimuli do not appear to overcome inattentional blindness.

Nerve Wrap for Local Delivery of FK506/Tacrolimus Accelerates Nerve Regeneration.

Peripheral nerve injuries (PNIs) occur frequently and can lead to devastating and permanent sensory and motor function disabilities. Systemic tacrolimus (FK506) administration has been shown to hasten recovery and improve functional outcomes after PNI repair. Unfortunately, high systemic levels of FK506 can result in adverse side effects. The localized administration of FK506 could provide the neuroregenerative benefits of FK506 while avoiding systemic, off-target side effects. This study investigates the utility of a novel FK506-impregnated polyester urethane urea (PEUU) nerve wrap to treat PNI in a previously validated rat infraorbital nerve (ION) transection and repair model. ION function was assessed by microelectrode recordings of trigeminal ganglion cells responding to controlled vibrissae deflections in ION-transected and -repaired animals, with and without the nerve wrap. Peristimulus time histograms (PSTHs) having 1 ms bins were constructed from spike times of individual single units. Responses to stimulus onsets (ON responses) were calculated during a 20 ms period beginning 1 ms after deflection onset; this epoch captures the initial, transient phase of the whisker-evoked response. Compared to no-wrap controls, rats with PEUU-FK506 wraps functionally recovered earlier, displaying larger response magnitudes. With nerve wrap treatment, FK506 blood levels up to six weeks were measured nearly at the limit of quantification (LOQ ≥ 2.0 ng/mL); whereas the drug concentrations within the ION and muscle were much higher, demonstrating the local delivery of FK506 to treat PNI. An immunohistological assessment of ION showed increased myelin expression for animals assigned to neurorrhaphy with PEUU-FK506 treatment compared to untreated or systemic-FK506-treated animals, suggesting that improved PNI outcomes using PEUU-FK506 is mediated by the modulation of Schwann cell activity.

Individual differences in inattentional blindness.

People often fail to notice unexpected objects and events when they are performing an attention-demanding task, a phenomenon known as inattentional blindness. We might expect individual differences in cognitive ability or personality to predict who will and will not notice unexpected objects given that people vary in their ability to perform attention-demanding tasks. We conducted a comprehensive literature search for empirical inattentional blindness reports and identified 38 records that included individual difference measures and met our inclusion criteria. From those, we extracted individual difference effect sizes for 31 records which included a total of 74 distinct, between-groups samples with at least one codable individual difference measure. We conducted separate meta-analyses of the relationship between noticing/missing an unexpected object and scores on each of the 14 cognitive and 19 personality measures in this dataset. We also aggregated across personality measures reflecting positive/negative affectivity or openness/absorption and cognitive measures of interference, attention breadth, and memory. Collectively, these meta-analyses provided little evidence that individual differences in ability or personality predict noticing of an unexpected object. A robustness analysis that excluded samples with extremely low numbers of people who noticed or missed produced similar results. For most measures, the number of samples and the total sample sizes were small, and larger studies are needed to examine individual differences in inattentional blindness more systematically. However, the results are consistent with the idea that noticing of unexpected objects or events differs from deliberate attentional control tasks in that it is not reliably predicted by individual differences in cognitive ability.

Similarity of an unexpected object to the attended and ignored objects affects noticing in a sustained inattentional blindness task.

When focusing attention on some objects and ignoring others, people often fail to notice the presence of an additional, unexpected object (inattentional blindness). In general, people are more likely to notice when the unexpected object is similar to the attended items and dissimilar from the ignored ones. Perhaps surprisingly, current evidence suggests that this similarity effect results almost entirely from dissimilarity to the ignored items, and it remains unclear whether similarity to the attended items affects noticing. Other aspects of similarity have not been examined at all, including whether the similarity of the attended and ignored items to each other affects noticing of a distinct unexpected object. We used a sustained inattentional blindness task to examine all three aspects of similarity. Experiment 1 (n = 813) found no evidence that increasing the similarity of the attended and ignored items to each other affected noticing of an unexpected object. Experiment 2 (n = 610) provided some of the first compelling evidence that similarity to the attended items - in addition to the ignored items - affects noticing. Experiment 3 (n = 1,044) replicated that pattern and showed that noticing rates varied with the degree of similarity to the ignored shapes but not to the attended shapes, suggesting that suppression of ignored items functions differently from the enhancement of attended items.

Cortical reintegration after facial allotransplantation.

Neural plasticity of the brain or its ability to reorganize following injury has likely coincided with the successful clinical correction of severe deformity by facial transplantation since 2005. In this study, we present the cortical reintegration outcomes following syngeneic hemifacial vascularized composite allograft (VCA) in a small animal model. Specifically, changes in the topographic organization and unit response properties of the rodent whisker-barrel somatosensory system were assessed following hemifacial VCA. Clear differences emerged in the barrel-cortex system when comparing naïve and hemiface transplanted animals. Neurons in the somatosensory cortex of transplanted rats had decreased sensitivity albeit increased directional sensitivity compared with naïve rats and evoked responses in transplanted animals were more temporally dispersed. In addition, receptive fields were often topographically mismatched with the indication that the mismatched topography reorganized within adjacent barrel (same row-arc bias following hemifacial transplant). These results suggest subcortical changes in the thalamus and/or brainstem play a role in hemifacial transplantation cortical plasticity and demonstrate the discrete and robust data that can be derived from this clinically relevant small animal VCA model for use in optimizing postsurgical outcomes.NEW & NOTEWORTHY Robust rodent hemifacial transplant model was used to record functional changes in somatosensory cortex after transplantation. Neurons in the somatosensory cortex of face transplant recipients had decreased sensitivity to stimulation of whiskers with increased directional sensitivity vs. naive rats. Transplant recipient cortical unit response was more dispersed in temporary vs. naive rats. Despite histological similarities to naive cortices, transplant recipient cortices had a mix of topographically appropriate and inappropriate whiskered at barrel cortex relationships.

A reproducible systematic map of research on the illusory truth effect.

People believe information more if they have encountered it before, a finding known as the illusory truth effect. But what is the evidence for the generality and pervasiveness of the illusory truth effect? Our preregistered systematic map describes the existing knowledge base and objectively assesses the quality, completeness and interpretability of the evidence provided by empirical studies in the literature. A systematic search of 16 bibliographic and grey literature databases identified 93 reports with a total of 181 eligible studies. All studies were conducted at Western universities, and most used convenience samples. Most studies used verbatim repetition of trivia statements in a single testing session with a minimal delay between exposure and test. The exposure tasks, filler tasks and truth measures varied substantially across studies, with no standardisation of materials or procedures. Many reports lacked transparency, both in terms of open science practices and reporting of descriptive statistics and exclusions. Systematic mapping resulted in a searchable database of illusory truth effect studies ( https://osf.io/37xma/ ). Key limitations of the current literature include the need for greater diversity of materials as stimuli (e.g., political or health contents), more participants from non-Western countries, studies examining effects of multiple repetitions and longer intersession intervals, and closer examination of the dependency of effects on the choice of exposure task and truth measure. These gaps could be investigated using carefully designed multi-lab studies. With a lack of external replications, preregistrations, data and code, verifying replicability and robustness is only possible for a small number of studies.

Consensus-based guidance for conducting and reporting multi-analyst studies.

Any large dataset can be analyzed in a number of ways, and it is possible that the use of different analysis strategies will lead to different results and conclusions. One way to assess whether the results obtained depend on the analysis strategy chosen is to employ multiple analysts and leave each of them free to follow their own approach. Here, we present consensus-based guidance for conducting and reporting such multi-analyst studies, and we discuss how broader adoption of the multi-analyst approach has the potential to strengthen the robustness of results and conclusions obtained from analyses of datasets in basic and applied research.

The Trajectory of Truth: A Longitudinal Study of the Illusory Truth Effect.

Repeated statements are rated as subjectively truer than comparable new statements, even though repetition alone provides no new, probative information (the illusory truth effect). Contrary to some theoretical predictions, the illusory truth effect seems to be similar in magnitude for repetitions occurring after minutes or weeks. This Registered Report describes a longitudinal investigation of the illusory truth effect (n = 608, n = 567 analysed) in which we systematically manipulated intersession interval (immediately, one day, one week, and one month) in order to test whether the illusory truth effect is immune to time. Both our hypotheses were supported: We observed an illusory truth effect at all four intervals (overall effect: χ 2(1) = 169.91; M repeated = 4.52, M new = 4.14; H1), with the effect diminishing as delay increased (H2). False information repeated over short timescales might have a greater effect on truth judgements than repetitions over longer timescales. Researchers should consider the implications of the choice of intersession interval when designing future illusory truth effect research.

Using the flicker task to estimate visual working memory storage capacity.

Studies of visual working memory (VWM) typically have used a "one-shot" change detection task to arrive at a capacity estimate of three to four objects, with additional limits imposed by the precision of the information needed for each object. Unlike the one-shot task, the flicker change detection task permits measurement of VWM capacity over time and with larger numbers of objects present in the scene, but it has rarely been used to assess the capacity of VWM. We used the flicker task to examine (a) whether capacity is close to the typical three to four items when using subtly different stimuli; (b) which dependent measure provides the most meaningful estimate of the capacity of VWM in the flicker task (response time or number of changes viewed); (c) whether capacity remains fixed at three to four items for displays containing many more objects; and (d) how VWM operates over time, with repeated opportunities to encode, retain, and compare elements in a display. Four experiments using grids of simple items varying only in luminance or color revealed a range for VWM capacity limits that was largely impervious to changes in display duration, interstimulus intervals, and array size. This estimate of VWM capacity was correlated with an estimate from the more typical one-shot task, further validating the flicker task as a tool for measuring the capacity of VWM.

Author Correction: A consensus-based transparency checklist.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Now or never: noticing occurs early in sustained inattentional blindness.

People can show sustained inattentional blindness for unexpected objects visible for seconds or even minutes. Would such objects eventually be noticed given enough time, with the likelihood of noticing accumulating while the unexpected object is visible? Or, is there a narrow window around onset or offset when an object is most likely to be detected, with the chances of noticing dropping outside of that window? Across three experiments (total n's = 283, 756, 488) exploring the temporal dynamics of noticing in sustained inattentional blindness, subjects who noticed the unexpected object did so soon after it onset. Doubling or even tripling the time when the unexpected object was visible barely affected the likelihood of noticing it and had no impact on how accurately subjects reported its features. When people notice an unexpected object in these sustained inattentional blindness tasks, they do so soon after the unexpected object onsets.

The spatial allocation of attention in an interactive environment.

Inattentional blindness methods allow for an unobtrusive measure of the spatial distribution of attention; because subjects do not expect the critical object, they have no reason to devote attention to task-irrelevant regions in anticipation of it. We used inattentional blindness to examine the spatial allocation of attention in an interactive game in which subjects navigated through a dynamic environment and avoided hazards. Subjects were most likely to notice unexpected objects in the areas with the greatest risk of contact with a hazard, and less likely to notice equally proximal objects in inaccessible areas of the display or areas in which hazards no longer posed a threat. These results suggest that both the content of the environment and how a subject can interact with it influence the spatial allocation of attention.

As if by Magic: An Abrupt Change in Motion Direction Induces Change Blindness.

Magicians claim that an abrupt change in the direction of movement can attract attention, allowing them to hide their method for a trick in plain sight. In three experiments involving 43 total subjects, we tested this claim by examining whether a sudden directional change can induce change blindness. Subjects were asked to detect an instantaneous orientation change of a single item in an array of Gabor patches; this change occurred as the entire array moved across the display. Subjects consistently spotted the change if it occurred while the array moved along a straight path but missed it when it occurred as the array changed direction. This method of inducing change blindness leaves the object in full view during the change; requires no additional distractions, visual occlusion, or global transients; and worked in every subject tested here. This phenomenon joins a body of magic-inspired work that yields insights into perception and attention.

Processing without noticing in inattentional blindness: A replication of Moore and Egeth (1997) and Mack and Rock (1998).

Surreptitious online measures can reveal the processing of stimuli that people do not report noticing or cannot describe. People seem to glean everything from low-level Gestalt grouping information to semantic meaning from unattended and unreported stimuli, and this information seems capable of influencing performance and of priming semantic judgments. Moore and Egeth (Journal of Experimental Psychology: Human Perception and Performance, 23, 339-352, 1997) provided evidence that judgments about the lengths of two lines were influenced by the grouping of background dots, even when subjects did not notice the pattern the dots formed. Mack and Rock (1998) reported that subjects could be primed to complete a stem with a word to which they were inattentionally blind. In this registered report, we replicated these two classic findings using large online samples (Ns = 260 and 448), finding support for the influence of grouping despite inattentional blindness, but not for word-stem priming.

65% of Americans believe they are above average in intelligence: Results of two nationally representative surveys.

Psychologists often note that most people think they are above average in intelligence. We sought robust, contemporary evidence for this "smarter than average" effect by asking Americans in two independent samples (total N = 2,821) whether they agreed with the statement, "I am more intelligent than the average person." After weighting each sample to match the demographics of U.S. census data, we found that 65% of Americans believe they are smarter than average, with men more likely to agree than women. However, overconfident beliefs about one's intelligence are not always unrealistic: more educated people were more likely to think their intelligence is above average. We suggest that a tendency to overrate one's cognitive abilities may be a stable feature of human psychology.

"The Job Has Become Advocating for the Job": Threats to Funding Dramatically Influence Program Outcomes.

As public health funding is increasingly threatened, a better understanding is needed about how periods of funding uncertainty impact program staff, activities, and outcomes. In North Carolina, 2 years of uncertainty and threats of funding cuts for a statewide youth tobacco prevention initiative contributed to reduced grantee morale and confidence about achieving program goals, displaced focus from core program activities, and caused premature loss of personnel, resulting in substantially reduced program activities and outcomes. The range of negative impacts of funding uncertainty and threats highlights the need for programs to create an infrastructure to support ongoing sustainability planning and activities.

Constraints on generality statements are needed to define direct replication.

Whether or not a replication attempt counts as "direct" often cannot be determined definitively after the fact as a result of flexibility in how procedural differences are interpreted. Specifying constraints on generality in original articles can eliminate ambiguity in advance, thereby leading to a more cumulative science.