Simmons Codey, Lendrum Robbie, Perkins Zane, Grier Gareth, Marsden Max
Institute of Pre-Hospital Care, London's Air Ambulance, London, UK.
Queen Mary University of London, London, UK.
Scand J Trauma Resusc Emerg Med. 2025 Jul 9;33(1):121. doi: 10.1186/s13049-025-01408-0.
The ability to measure a clinician's cognitive load allows task adaptions to optimise performance. The aim of this study was to identify cognitive load tools suitable for use by pre-hospital clinicians performing REBOA and develop a bespoke pre-hospital REBOA cognitive load assessment tool.
A scoping review was conducted, following the PRISMA guidelines, to identify different cognitive load assessment tools in the literature from inception to January 2023. A qualitative narrative synthesis was used to compare tools based on their type, frequency of use, and context. Tools were assessed for contextual relevance and practical application to REBOA using defined criteria (CMTA-R score), created using domain experts.
Forty-nine articles were included for review, identifying 21 unique cognitive load tools: 10 subjective and 11 objective. The NASA-TLX was the most frequently used subjective tool (17 studies), scoring highest for potential REBOA use (CMTA-R 17). Heart Rate Variability (HRV) was the most common objective measure (14 studies), with a CMTA-R score of 13. A bespoke REBOA modification of the NASA-TLX, was suggested to quantify post-procedure cognitive load.
This scoping review identifies the NASA-TLX and HRV as potential tools for assessing cognitive load during prehospital REBOA. A bespoke REBOA-adapted NASA-TLX, could be used post-procedure, while intra-procedural HRV monitoring could provide real-time data. Future research should validate this approach in clinical settings.
测量临床医生认知负荷的能力有助于调整任务以优化表现。本研究的目的是确定适合院前临床医生在进行可挽救性血管内球囊阻断术（REBOA）时使用的认知负荷工具，并开发一种定制的院前REBOA认知负荷评估工具。
按照PRISMA指南进行了一项范围综述，以确定从开始到2023年1月文献中不同的认知负荷评估工具。采用定性叙述性综合方法，根据工具的类型、使用频率和背景对工具进行比较。使用由领域专家创建的既定标准（CMTA-R评分），评估工具与REBOA的背景相关性和实际应用情况。
纳入49篇文章进行综述，确定了21种独特的认知负荷工具：10种主观工具和11种客观工具。美国国家航空航天局任务负荷指数（NASA-TLX）是最常用的主观工具（17项研究），在REBOA潜在使用方面得分最高（CMTA-R为17）。心率变异性（HRV）是最常见的客观测量方法（14项研究），CMTA-R评分为13。建议对NASA-TLX进行定制的REBOA修改，以量化术后认知负荷。
本范围综述确定NASA-TLX和HRV是评估院前REBOA期间认知负荷的潜在工具。一种定制的适用于REBOA的NASA-TLX可在术后使用，而术中HRV监测可提供实时数据。未来的研究应在临床环境中验证这种方法。
