Page 79 - JSOM Spring 2020

Methods Criteria for inclusion were as follows: (1) study available in
English or able to be translated into English, (2) study avail-
Search Strategy able in full text, (3) study used human participants only, and
A two-stage approach was used to identify studies that were (4) participants in the study completed a single-task and mul-
relevant for initial assessment to include in this review. The titask paradigm. After the studies were subjected to the inclu-
first stage consisted of a cursory review of current litera- sion criteria, full-text of the remaining studies were screened
ture, which helped formulate the search strategy. Key search using the following criteria for exclusion: (1) all participants
terms were selected by extracting commonly used terms in the in the study were not identified as tactical athletes, (2) study
known literature that were relevant to this review. Final search was a nonresearch article (e.g., editorials, letters), critical or
terms were established and used for a more robust literature systematic review, or case study or series, and (3) statistical
review. The second stage consisted of applying the final search analyses were not performed to compare single-task perfor-
terms into PubMed, Web of Science, SPORTDiscus, and De- mance to multitask performance.
fense Technical Information Center (DTIC) databases. Search
terms were adjusted as needed to meet the search strategies In an effort to reduce bias and screen the studies accurately,
of each database (Table 1). Across all databases, advanced two authors (MKT, MPB) independently reviewed and
search options included human-only research studies, those in screened studies from databases using the inclusion and exclu-
English, and those published from 01 January 2000 to 01 June sion criteria. Author consensus was achieved through discus-
2018.
sion and mediated by a third author (JAO).
TABLE 1 Databases and Search Terms Used During Literature
Search Additional relevant studies and grey literature were identi-
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Database Search Terms fied from references found in the selected studies and from
(“Military Personnel”[Mesh] OR “military known researchers in the field.
personnel”[All Fields] OR “Psychology,
Military”[Mesh] OR “military”[All Fields]
OR “Veterans”[Mesh] OR “veteran”[All Quality Review and Data Extraction
Fields] OR “soldier”[All Fields] OR “armed Each article that met the inclusion and exclusion criteria was
PubMed forces personnel”[All Fields] OR “Police” assessed independently by two authors (MKT, MPB) for meth-
[Mesh] OR “police”[All Fields] OR
“law enforcement”[Mesh] OR “law odological quality using the scale by Tooth et al., which is
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enforcement”[All Fields]) AND ((“dual-task” a validated and reliable list of criteria for evaluating threats
[All Fields] OR “dual task”[All Fields] to internal and external validity in observational studies. This
OR “multitask”[All Fields] OR “multitask”
[All Fields]) OR “multitasking”[All Fields]) scale has 33 questions covering the areas of recruitment, data
((TS=(military OR armed services OR army collection, biases, data analysis, study population, and gen-
OR soldier OR veteran OR police OR law eralizability. The maximum possible score is 33, with higher
Web of Science enforcement)) AND ((TS=((dual OR multi) AND scores indicating greater methodological quality.
task)) OR (TS=(dual-task OR multitask OR
multitasking)))) Interrater agreement between authors for quality review ques-
TX (military or veteran or soldier or armed tions for each article was calculated using a Cohen kappa co-
forces or army or police or law enforcement)
SPORTDiscus efficient (κ). We interpreted κ values as follows: >0.80, almost
AND TX (dual task or dual-task or multitask or
multitask or multitasking) perfect; 0.61-0.80, substantial; 0.41-0.60, moderate; 0.21-
(“dual-task” OR “multitask” OR multitask) 0.40, fair; <0.20, slight. 37
DTIC
AND “Performance human”
Note: Filters were applied to search only for human subjects research Once methodological quality of the studies was completed,
and articles in English. data were extracted by one author (MKT) from the included
studies for authors, title, date of publication, country, study
design and setting, sample size, participant demographics, sin-
Inclusion and Exclusion Criteria
gle- and multitask paradigms, results, and key findings. If the
Upon the initial search, all articles were screened by title and author was unclear on details to be extracted or how data
abstract to determine if the article met the relevance and objec- were to be presented, consensus was achieved through discus-
tives of this review. Authors (MKT, MPB) were presented with sion with other authors (MPB, JAO).
definitions of single- and multitask prior to database searches
to maintain consistent screening guidelines. Single-task was Results
defined as the completion of one task or test independently
of other tasks or tests. Multitask was defined as the comple- Study Selection and Demographics
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tion of two or more tasks or tests concurrently. Dual-task The PRISMA flow diagram (Figure 1) details the process by
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is the performance of two tasks concurrently 7,10,23 which was which the research articles were selected during the review
included as a multitask paradigm during the literature search. process. Database search results prior to screening and re-
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Additionally, authors were presented the definition of “tactical moval of duplicates are also provided. A total of 1632 stud-
athlete” as personnel who currently has or previously had oc- ies were identified across the databases with an additional 15
cupational duties that constitute or require planned actions to studies included through other sources. Screening of titles and
gain a military-like end or result. Examples of tactical athletes abstracts resulted in 78 studies, following removal of 22 du-
include (but not limited to) law enforcement, soldiers, cadets, plicates, to be reviewed for inclusion and exclusion criteria.
and veterans. Once articles were selected via title and abstract,
duplicates were removed, and each article was screened for In total, 14 studies were identified as eligible to be included in
inclusion and exclusion criteria. the review (Table 2). All except two studies 39,40 were conducted

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