Clinician awareness of brain computer interfaces: a Canadian national survey

Abstract

Background: Individuals with severe neurological disabilities but preserved cognition, including children, are often precluded from connecting with their environments. Brain computer interfaces (BCI) are a potential solution where advancing technologies create new clinical opportunities. We evaluated clinician awareness as a modifiable barrier to progress and identified eligible populations. Methods: We executed a national, population-based, cross-sectional survey of physician specialists caring for persons with severe disability. An evidence-and experience-based survey had three themes: clinician BCI knowledge, eligible populations, and potential impact. A BCI knowledge index was created and scored. Canadian adult and pediatric neurologists, physiatrists and a subset of developmental pediatricians were contacted. Secure, web-based software administered the survey via email with online data collection. Results: Of 922 valid emails (664 neurologists, 253 physiatrists), 137 (15%) responded. One third estimated that ≥10% of their patients had severe neurological disability with cognitive capacity. BCI knowledge scores were low with > 40% identifying as less than "vaguely aware" and only 15% as "somewhat familiar" or better. Knowledge did not differ across specialties. Only 6 physicians (4%) had patients using BCI. Communication and wheelchair control rated highest for potentially improving quality of life. Most (81%) felt BCI had high potential to improve quality of life. Estimates suggested that > 13,000 Canadians (36 M population) might benefit from BCI technologies. Conclusions: Despite high potential and thousands of patients who might benefit, BCI awareness among clinicians caring for disabled persons is poor. Further, functional priorities for BCI applications may differ between medical professionals and potential BCI users, perhaps reflecting that clinicians possess a less accurate understanding of the desires and needs of potential end-users. Improving knowledge and engaging both clinicians and patients could facilitate BCI program development to improve patient outcomes.

Brain–Computer Interfaces in Neurorecovery and Neurorehabilitation

“…96,98 From a clinical standpoint, many patients and clinicians lack actionable knowledge about BCIs and how they can be applied toward care. 122 For clinicians actively caring for patients with BCIs, relevant outcome measures and methods for evaluating performance and patient satisfaction may be opaque. Closer collaboration among engineers, clinicians, patient advocates, and other stakeholders will be instrumental in ensuring that clinical outcome measures are clear, patient priorities are met, risk-benefit balance is optimized, and public-health impact is maximized.…”

Advancing Brain-Computer Interface Applications for Severely Disabled Children Through a Multidisciplinary National Network: Summary of the Inaugural Pediatric BCI Canada Meeting

“…Despite its significant potential, modern BCI systems and applications suffer from several limitations, which are only compounded when implementing programs with pediatric populations (Mikoajewska and Mikoajewski, 2014 ; Kinney-Lang et al, 2016 ; Letourneau et al, 2020 ). Such barriers exist across the BCI experience: from technological limitations, through design issues affecting user-experience, to long-term implementation challenges (Millán et al, 2010 ; Powers et al, 2015 ; Lazarou et al, 2018 ; Lotte et al, 2018 ).…”

“…Pediatric brain-computer interface (BCI) is a rapidly developing subfield of BCI research, with its unique challenges, barriers, and advantages (Mikoajewska and Mikoajewski, 2014 ; Alves et al, 2016 ; Chau and Fairley, 2016 ; Kinney-Lang et al, 2016 ; Norton et al, 2018 ; Zhang et al, 2019 ). As awareness of the technology continues to grow in both research and clinical spheres (Kinney-Lang et al, 2016 ; Letourneau et al, 2020 ), so does the need for connecting pediatric BCI expertise. Building up cooperation between researchers, clinicians and stakeholders will be critical in the coming years to raise pediatric BCI to its full potential.…”

Brain-Computer Interface for children: state-of-the-art and challenges

“…Despite the potential of the BCIs and the resulting spreading of BCI applications, the current research has been focused on adults with relative neglect of the pediatric population [20]. Such limitation further reduces the development of this technology and restricts the possibilities that also children could benefit from it [21].…”

“…We found 34 studies ( [20]- [53]), but three works [46]- [48] were not included, because the authors present BCI applications (game, rehabilitative robot) designed for children, without providing experimental results on minors. We categorize the 31 remaining studies according to the areas of application of BCI and the kind of work including:…”