JDREAM. Journal of interDisciplinary REsearch Applied to Medicine JDREAM (2021), v. 5 i. 1, 11-18 ISSN 2532-7518 DOI 10.1285/i25327518v5i1p11 http://siba-ese.unisalento.it, © 2021 Università del Salento 11 The Eye-tracking technology in the healthcare settings: an observational, cross sectional, multicenter study Luana Conte 1,2 ; Alessia Lezzi 3 ; Roberto Lupo 4 Simone Zacchino 3 , Antonino Calabrò 5 ; Cosimo Petrelli 4 ; Cosimo Caldararo 6 ; Antonietta Abate 7 ; Alessandra Rizzo 8 ; Fiorella Fabrizio 9 ; Maicol Carvello 10 ; Maria Chiara Carriero 11 1 Laboratory of Interdisciplinary Research Applied to Medicine, University of Salento and ASL (Local Health Authority), Lecce, Italy 2 Laboratory of Biomedical Physics and Environment, Department of Mathematics and Physics, University of Salento, Lecce, Italy 3 Ant Italia onlus (Associazione Nazionale Tumori) Lecce, Italy 4 “San Giuseppe da Copertino” Hospital, ASL (Local Health Authority) Lecce, Italy 5 “Nuovo Ospedale degli Infermi” Hospital ASL (Local Health Authority) Biella, Italy 6 University of Bari, Italy 7 “EuroItalia” Centre, Casarano, Lecce, Italy 8 “Santissima Annunziata Hospital” Asl (Local Health Authority) Taranto, Italy 9 “Vito Fazzi” Hospital, ASL (Local Health Authority) Lecce, Italy 10” Brisighella Community” Hospital, ASL (Local Health Authority) Romagna, Brisighella, Ravenna, Italy 11 “Santa Chiara” Institute, Rome, Italy Corresponding author: Luana Conte luana.conte@unisalento.it Abstract Successful communication is considered an essential component of the quality of care and safety of the patient with Amyotrophic Lateral Sclerosis (ALS). Recent technology has provided alternative communication systems, including the Eye-tracking technology, which enables interaction with others in the more advanced stages of the disease. The aim of the study is to investigate patients' difficulties in using the eye tracker, their problem in ob- taining the device and the clinical complications resulting from it. A “snowball sampling” method study was conducted from April to September 2020 until sample saturation. The results of the study demonstrate the countless difficulties in obtaining the eye- tracker, with long waiting times, which are not followed by adequate training in its correct use. Among the consequences linked to the use of this device, the most frequent were nys- tagmus (8.8%), onset of eyelid ptosis (16.2%) and the appearance of increased fatigue. 56.1% of the sample used the eye tracker to surf the Internet whereas 9.1% used it to write e-mails. Overall, the use of the eye tracker led to an improvement in overall quality of life (24%). In Conclusions, the Eye-tracking technology is a valuable de- vice for Alternative Augmentative Communication (AAC) in ALS patients and can be used with good perfor- mance, therefore the need for information, training and improvement on this topic is essential Keywords: Eye-tracking technology, Eye tracker, Amyotrophic Lateral Sclerosis 1. Introduction The incidence of Amyotrophic Lateral Sclerosis (ALS) is about 1-3 cases per 100,000 inhabit- ants per year and the relationship between physical impairment and psychological condi- tion is an important issue that involves a direct correlation between severity of depression and physical disability. In recent decades, the pro- gress of biomedical technologies has led to great benefits in the field of healthcare, with the aim of improving the health of individuals and offering alternative solutions to traumas and various diseases. Among these, ALS patients have always used computer media, including computers, writing and digital language systems to communicate with the outside world. (Beukelman and Mirenda, 2014). Studies on the mental evaluation of ALS patients have report- ed complaints such as depression, anxiety, loss of emotional control and alienation, as well as a high risk of suicide in the early stages of the disease (Cui et al., 2015). In the presence of this debilitating neurodegenerative disease, the