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Nataraj M, Maiya GA, Nagaraju SP, Shastry BA, N SK, Shetty S, Raje S. Exploring extended reality for diabetes education & self-management - A bibliometric analysis from 1999 to 2023. Diabetes Metab Syndr 2024; 18:103071. [PMID: 38991431 DOI: 10.1016/j.dsx.2024.103071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 06/26/2024] [Accepted: 06/30/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Diabetes Mellitus (DM) has emerged as a rapidly growing non-communicable disease (NCD) across developed & developing countries. People with diabetes mellitus experience health implications. They develop associated microvascular complications such as neuropathy, nephropathy & retinopathy and macro-vascular complications like coronary artery disease, stroke, amputations etc. These complications increase the socio-economic burden of people living with diabetes. Self-management of diabetes through education is a strong tool that remains under-utilized in clinical settings. The objective of the present study was to explore the role of extended reality for diabetes education & self-management. METHODOLOGY The present study is a bibliometric analysis performed on the Scopus database with keywords: diabetes education, self-management, extended reality, virtual reality, augmented reality, mixed reality, and Boolean operators AND, OR. The search period ranged from inception till 4th July 2023 with restriction to English language articles. A total of 89 documents were identified in Scopus under multiple domains such as Engineering, Medicine, Health Professions, Nursing among others. The data was exported to the VOS Viewer software for network analysis. RESULTS Out of the total 89 documents, 45-original research, 26-review, 12-conference paper, 3-book, 2-book chapters & 1-note. The highest publications were from the Medicine category. The year of publication of the included documents ranged from 1999 till 2022. The network analysis was performed to explore the association between the included studies (co-authorship, co-occurrence, citation analysis, bibliographic coupling). CONCLUSION The network analysis found the USA to be the leading publisher and the National Institute of Health (NIH) to be the leading funding source. There is limited evidence and a strong future scope to strengthen research productivity on extended reality for diabetes education & self-management.
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Affiliation(s)
- Megha Nataraj
- Department of Physiotherapy, Centre for Podiatry & Diabetic Foot Care and Research, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, 576104, Karnataka, India.
| | - G Arun Maiya
- Department of Physiotherapy, Centre for Podiatry & Diabetic Foot Care and Research, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, 576104, Karnataka, India.
| | - Shankar Prasad Nagaraju
- Department of Nephrology, Kasturba Medical College (KMC) - Manipal, Manipal Academy of Higher Education (MAHE), Manipal, 576104, Karnataka, India.
| | - Barkur Ananthakrishna Shastry
- Department of Medicine, Kasturba Medical College (KMC) - Manipal, Manipal Academy of Higher Education (MAHE), Manipal, 576104, Karnataka, India.
| | - Shivashankara K N
- Department of Medicine, Kasturba Medical College (KMC) - Manipal, Manipal Academy of Higher Education (MAHE), Manipal, 576104, Karnataka, India.
| | - Sahana Shetty
- Department of Endocrinology, Kasturba Medical College (KMC)- Manipal, Manipal Academy of Higher Education (MAHE), Manipal, 576104, Karnataka, India.
| | - Sohini Raje
- Department of Physiotherapy, Centre for Podiatry & Diabetic Foot Care and Research, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, 576104, Karnataka, India.
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Finch E, Coleman A, Cameron A, Moro C. Utilising interactive technology for stroke patient education: a systematic review. Disabil Rehabil Assist Technol 2024; 19:1236-1248. [PMID: 36622858 DOI: 10.1080/17483107.2022.2161649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 10/26/2022] [Accepted: 12/16/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE As a leading cause of death and disability worldwide, how to effectively manage and prevent stroke is a key consideration for health care systems. Throughout the world stroke management recommendations include education; however, not all patients receive this intervention. Advances in technology have provided health professionals with a range of innovative, effective, and modern tools that may be useful in delivering stroke education. This study aimed to systematically review the current evidence for the use of interactive technology in stroke patient education, and whether this was effective for increasing patients' stroke knowledge and behaviours that lower stroke risk. METHODS AND MATERIALS The protocol was registered with PROSPERO (#225223) and a literature search undertaken in Embase (including MEDLINE and PubMed), PsycInfo and CINAHL from inception until August 2022. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the included articles. RESULTS From an initial yield of 760 articles, 10 articles met the study inclusion criteria. The articles explored a range of interactive technologies, with none of them includes articles using the same technology. All of the articles reported at least one positive effect from the technology. Two articles reported on stroke incidence post-intervention. The methodological quality of the articles varied, but was largely medium to high. CONCLUSION The paucity of evidence highlights a need for future studies to provide insights into the benefits of quality interactive technology-based stroke education and to identify options for optimal delivery modes in stroke education.
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Affiliation(s)
- Emma Finch
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Speech Pathology Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Adele Coleman
- Speech Pathology Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Ashley Cameron
- Speech Pathology Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- Clinical Support Services, Metro South Health, Brisbane, Australia
| | - Christian Moro
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
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Colback AA, Velazquez-Castro O, Agarrado M, Reddy R, Strong EB, Wilson M, Strong EB. Evaluating Mixed Reality as a Tool for Patient Education of Facial Fractures. Facial Plast Surg Aesthet Med 2024. [PMID: 38530099 DOI: 10.1089/fpsam.2023.0302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
Background: Patients may be educated about facial fractures using two-dimensional computed tomography (2DCT); however, three-dimensional mixed reality (3DMR) goggles may improve patient education by delivering content in an immersive environment. Objective: To compare the effectiveness of 2DCT and 3DMR formats used for patient education on facial fractures, as measured by surveys. Methods: In this prospective, randomized, crossover study, video tutorials intended for facial fracture informed consent were created in 2DCT and 3DMR formats from a single CT data set of a zygomaticomaxillary complex (ZMC) fracture. Subjects were randomly assigned into two groups. Group 1 (n = 25) viewed the 2DCT tutorial, answered self-assessment and information recall surveys, viewed the 3DMR tutorial, repeated the prior surveys as well as a comparison survey. Group 2 (n = 25) followed the same sequence but viewed the 3DMR tutorial and then the 2DCT tutorial. Results: Participants (n = 50) had no differences in age (group 1-51.9 years/standard deviation [SD] 20.9; group 2-44.7 years/SD 17.6 years; p = 0.223), gender (group 1-10 male/15 female; group 2-11 male/14 female; p = 0.999), college education level (group 1-25 yes; group 2-25 yes; p = 0.844), or prior 2DCT or 3DMR experience (group 1-9 yes/16 no; group 2-13 yes/12 no; p = 0.393). The 3DMR format was preferred over 2DCT (p < 0.05), and it was reported to enhance understanding as compared to 2DCT (p < 0.05). No differences for information recall were noted (p = 0.753). Conclusion: In this study, participants preferred 3DMR goggles over 2DCT for a simulated ZMC fracture-informed consent.
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Affiliation(s)
- Angela A Colback
- University of California, Davis-School of Medicine, Sacramento, California, USA
| | | | - Michael Agarrado
- University of California, Davis-School of Medicine, Sacramento, California, USA
| | - Renuka Reddy
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
| | - E Brandon Strong
- Department of BioEngineering, University of California, Berkeley, Berkeley, California, USA
| | - Machelle Wilson
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - E Bradley Strong
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
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Romalee W, Tsai FT, Hsu YC, Hsu ML, Wang DH. Effectiveness of mobile augmented reality-integrated oral health education for community-dwelling older adults: A randomized controlled trial. Arch Gerontol Geriatr 2024; 117:105277. [PMID: 37995647 DOI: 10.1016/j.archger.2023.105277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/31/2023] [Accepted: 11/11/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND & PURPOSE Oral health education helps older adults optimize their oral health. However, traditional lecture-based oral health education has limitations, exacerbated by the COVID-19 pandemic. Mobile augmented reality (MAR) has emerged as an alternative educational method. This study compared the effectiveness of MAR-integrated oral health education with that of lecture-based education and no education. METHODS This parallel, randomized controlled, open-label trial enrolled 75 older adults from six activity centers. The participants were randomly assigned, by a random number table technique, to the lecture-based, MAR, or control group. Data on oral healthcare-related knowledge, self-efficacy, and oral health status were collected through questionnaires and oral examinations at baseline, immediately after the intervention, and at a 2-week follow-up. The MAR system's usability was assessed. Statistical analyses, comprising descriptive statistics and inferential tests, were performed. RESULTS Data from 61 participants were analyzed, 22 in the lecture-based group, 20 in the MAR group, and 19 in the control group. Both lectures and MAR education significantly improved oral health status. However, changes in knowledge and self-efficacy scores were significantly different only for the MAR versus control group (p = .002 and .001, respectively). The MAR group demonstrated better knowledge and self-efficacy retention than did the lecture-based group, without significant difference. Usability assessment revealed potential for improvement in the MAR system. CONCLUSIONS MAR-integrated oral health education enhanced the knowledge, self-efficacy, and oral health status of community-dwelling older adults. However, addressing technology adoption and usability challenges is vital. Longer-term evaluations and broader geographical studies are recommended.
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Affiliation(s)
- Worachate Romalee
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Community Dentistry & Gerodontology, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Fa-Tzu Tsai
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Chen Hsu
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ming-Lun Hsu
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan; School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Ding-Han Wang
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Miller CA, Locke RA, Holck HW, Evans HJ, Bhamber TP, Sinks AL, McGrath LG, Boselli DM, Clark PE, Roy OP. Evaluation of a novel augmented reality educational tool and its effects on patient experience: A randomized controlled trial. Indian J Urol 2024; 40:25-30. [PMID: 38314074 PMCID: PMC10836458 DOI: 10.4103/iju.iju_191_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/18/2023] [Accepted: 12/12/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Patient education is an essential element of the treatment pathway. Augmented reality (AR), with disease simulations and three-dimensional visuals, offers a developing approach to patient education. We aim to determine whether this tool can increase patient understanding of their disease and post-visit satisfaction in comparison to current standard of care (SOC) educational practices in a randomized control study. Methods Our single-site study consisted of 100 patients with initial diagnoses of kidney masses or stones randomly enrolled in the AR or SOC arm. In the AR arm, a physician used AR software on a tablet to educate the patient. SOC patients were educated through traditional discussion, imaging, and hand-drawn illustrations. Participants completed pre- and post-physician encounter surveys adapted from the Press Ganey® patient questionnaire to assess understanding and satisfaction. Their responses were evaluated in the Readability Studio® and analyzed to quantify rates of improvement in self-reported understanding and satisfaction scores. Results There was no significant difference in participant education level (P = 0.828) or visit length (27.6 vs. 25.0 min, P = 0.065) between cohorts. Our data indicate that the rate of change in pre- to post-visit self-reported understanding was similar in each arm (P ≥ 0.106 for all responses). The AR arm, however, had significantly higher patient satisfaction scores concerning the educational effectiveness and understanding of images used during the consultation (P < 0.05). Conclusions While AR did not significantly increase self-reported patient understanding of their disease compared to SOC, this study suggests AR as a potential avenue to increase patient satisfaction with educational tools used during consultations.
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Affiliation(s)
- Caroline A. Miller
- University of North Carolina School of Medicine, Chapel Hill, Charlotte, North Carolina, USA
| | - Rachel A. Locke
- Department of Urology, Atrium Health Levine Cancer Institute, Charlotte, North Carolina, USA
| | - Hailey W. Holck
- University of Texas Southwestern Medical School, Dallas, Texas, USA
| | - Holt J. Evans
- Edward Via College of Osteopathic Medicine, Spartanburg, South Carolina, USA
| | - Tiag P. Bhamber
- University of Florida College of Medicine, Jacksonville, Florida, USA
| | - Alexander L. Sinks
- Wake Forest School of Medicine, Winston-Salem, Charlotte, North Carolina, USA
| | - Lila G. McGrath
- Department of Urology, Atrium Health Levine Cancer Institute, Charlotte, North Carolina, USA
| | - Danielle M. Boselli
- Department of Biostatistics, Levine Cancer Institute, Charlotte, North Carolina, USA
| | - Peter E. Clark
- Department of Urology, Atrium Health Levine Cancer Institute, Charlotte, North Carolina, USA
| | - Ornob P. Roy
- Department of Urology, Atrium Health Levine Cancer Institute, Charlotte, North Carolina, USA
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Kim S, Jung T, Sohn DK, Chae Y, Kim YA, Kang SH, Park Y, Chang YJ. The Multidomain Metaverse Cancer Care Digital Platform: Development and Usability Study. JMIR Serious Games 2023; 11:e46242. [PMID: 38032697 PMCID: PMC10722376 DOI: 10.2196/46242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/17/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND As cancer treatment methods have diversified and the importance of self-management, which lowers the dependence rate on direct hospital visits, has increased, effective cancer care education and management for health professionals and patients have become necessary. The metaverse is in the spotlight as a means of digital health that allows users to engage in cancer care education and management beyond physical constraints. However, it is difficult to find a multipurpose medical metaverse that can not only be used in the field but also complements current cancer care. OBJECTIVE This study aimed to develop an integrated metaverse cancer care platform, Dr. Meta, and examine its usability. METHODS We conducted a multicenter, cross-sectional survey between November and December 2021. A descriptive analysis was performed to examine users' experiences with Dr. Meta. In addition, a supplementary open-ended question was used to ask users for their suggestions and improvements regarding the platform. RESULTS Responses from 70 Korean participants (male: n=19, 27% and female: n=51, 73%) were analyzed. More than half (n=37, 54%) of the participants were satisfied with Dr. Meta; they responded that it was an interesting and immersive platform (n=50, 72%). Less than half perceived no discomfort when using Dr. Meta (n=34, 49%) and no difficulty in wearing and operating the device (n=30, 43%). Furthermore, more than half (n=50, 72%) of the participants reported that Dr. Meta would help provide non-face-to-face and noncontact services. More than half also wanted to continue using this platform in the future (n=41, 59%) and recommended it to others (n=42, 60%). CONCLUSIONS We developed a multidomain metaverse cancer care platform that can support both health professionals and patients in non-face-to-face cancer care. The platform was uniquely disseminated and implemented in multiple regional hospitals and showed the potential to perform successful cancer care.
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Affiliation(s)
- Sunghak Kim
- Division of Cancer Control and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Timothy Jung
- Faculty of Business and Law, Manchester Metropolitan University, Manchester, United Kingdom
| | - Dae Kyung Sohn
- Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Yoon Chae
- Division of Cancer Control and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Young Ae Kim
- National Cancer Survivorship Center, National Cancer Center, Goyang, Republic of Korea
| | - Seung Hyun Kang
- Planning Division, Korea Smart Healthcare Association, Seoul, Republic of Korea
| | - Yujin Park
- Division of Cancer Control and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Yoon Jung Chang
- Division of Cancer Control and Policy, National Cancer Center, Goyang, Republic of Korea
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Romalee W, Tsai FT, Hsu YC, Hsu ML, Wang DH. A mobile augmented reality-integrated oral health education for community dwelling older adults: A pilot study. J Dent Sci 2023; 18:1838-1844. [PMID: 37799934 PMCID: PMC10548049 DOI: 10.1016/j.jds.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/16/2023] [Indexed: 10/07/2023] Open
Abstract
Background/purpose Providing oral healthcare education can be an optimal strategy for imparting knowledge and developing self-care skills for older adults to enhance their oral health conditions. However, traditional passive lecture-based education programs have several limitations. Integrating mobile augmented reality (MAR) into oral health education can potentially enhance the effectiveness of the education by mitigating those limitations. The objectives of this study are to develop and evaluate the effectiveness of MAR-integrated oral health education. The objectives of this study were to develop and evaluate the effectiveness of MAR-integrated oral health education. Materials and methods Twenty-four older adults from community dwellings participated in this study. The participants received MAR-integrated oral health education once at activity centers. Self-report questionnaires were utilized to assess oral healthcare-related knowledge and self-efficacy, and the usability score of the MAR system. The assessment was conducted before and after the educational program. Data were statistically analyzed using descriptive statistics and paired-t test. Results The mean scores of oral healthcare-related knowledge and self-efficacy showed a significant increase after the educational program, with P-values of <0.001 and 0.002, respectively. A majority of the participants exhibited a lack of knowledge and self-efficacy regarding the proper selection of toothpaste and interdental brushes. However, there was an improvement after the intervention. The usability score of the system was lower than the average level. Conclusion MAR-integrated oral health education effectively increases oral health-related knowledge and self-efficacy among community dwelling older adults. Still, the usability of the MAR system needs to be improved. Further investigation of long-term effects and clinical outcomes, and the inclusion of comparative groups are recommended for the future study.
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Affiliation(s)
- Worachate Romalee
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Community Dentistry & Gerodontology, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Fa-Tzu Tsai
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Chen Hsu
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ming-Lun Hsu
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ding-Han Wang
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Sukotjo C, Bertucci DE, Patel JY, Yuan JCC, Santoso M. Evaluating augmented reality e-typodont to improve a patient's dental implant health literacy. J Prosthet Dent 2023:S0022-3913(23)00539-5. [PMID: 37714746 DOI: 10.1016/j.prosdent.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 09/17/2023]
Abstract
STATEMENT OF PROBLEM Information regarding dental implants can be difficult to understand for participants. Improving patients' dental implant health literacy remains a challenging process. PURPOSE The purpose of this clinical study was to develop and evaluate patients' understanding of the implant treatment procedure, components, and sequences using traditional typodont and augmented reality (AR) applications (e-typodont), with the goal of improving their oral health literacy. MATERIAL AND METHODS Participants who had sought dental implant treatment at the group practice and implant clinic at the University of Illinois Chicago (UIC) College of Dentistry were invited to enroll in this study. Participants were asked to fill out the first questionnaire (Q1) assessing their understanding of implant treatment procedures, components, and sequences. The participants were randomly exposed to 1 of the 2 modes of delivering education, typodont or AR e-typodont. The participants were asked to complete the additional 2 questionnaires (Q2 and Q3), and the posttest questionnaire (Q1) to re-evaluate their understanding of the implant treatment procedure, components, and sequences. All data were entered and coded into a spreadsheet. Descriptive (mean) and statistical (Wilcoxon Signed Ranks and Mann-Whitney U test) analyses were used (α=.05). RESULTS Both interventions significantly increased participants' understanding of implant treatments (typodont: P=.004; e-typodont: P<.001), implant components (typodont: P=.003; e-typodont: P<.001), and implant treatment sequences (typodont: P=.001; e-typodont: P<.001). The e-typodont group significantly improved participants' understanding of implant treatments (P=.006), implant components (P=.023), and implant treatment sequences (P=.008) compared with the typodont group. Participants perceived the e-typodont mode of delivery to be significantly more interesting (P=.002), interactive (P=.008), educational (P=.002), user-friendly (P=.016), and "Wow" (P=.002) compared with the traditional typodont mode of delivery. CONCLUSIONS Both interventions improved participants' understanding of implant treatment procedures, components, and sequences. The e-typodont showed better improvement in participants' understanding of dental implants compared with the traditional typodont.
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Affiliation(s)
- Cortino Sukotjo
- Professor and Director, Predoctoral Implant Program, Department of Restorative Dentistry, College of Dentistry, University of Illinois Chicago, Chicago, Ill.
| | - Dominique Erica Bertucci
- Resident, Pediatric Dentistry, Children's Hospital Colorado Anschutz Medical Campus, Aurora, Colo
| | | | - Judy Chia-Chun Yuan
- Associate Professor and Interim Assistant Dean for Clinical Affairs, Department of Restorative Dentistry, College of Dentistry, University of Illinois Chicago, Chicago, Ill
| | - Markus Santoso
- Assistant Professor, Digital Worlds Institute, University of Florida, Gainesville, Fla
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Urlings J, Abma I, Aquarius R, Aalbers M, Bartels R, Maal T, Henssen D, Boogaarts J. Augmented reality-The way forward in patient education for intracranial aneurysms? A qualitative exploration of views, expectations and preferences of patients suffering from an unruptured intracranial aneurysm regarding augmented reality in patient education. Front Bioeng Biotechnol 2023; 11:1204643. [PMID: 37600319 PMCID: PMC10436540 DOI: 10.3389/fbioe.2023.1204643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/10/2023] [Indexed: 08/22/2023] Open
Abstract
Objectives: The goal of this project is to explore the views, expectations and preferences of patients with an unruptured intracranial aneurysm regarding the use of AR in patient education. Methods: To gain an in-depth understanding of the patients' perspective, a face-to-face interview study was conducted using an interview protocol with a predefined topic list. All interviews were audio-recorded and transcribed verbatim afterwards. Transcripts were analyzed using thematic content analyses. Coding was performed using Atlas.ti software. Results: Seventeen interviews were conducted. The views, expectations and preferences of patients regarding patient education with AR could be subdivided into 15 categories, which could be grouped into 4 general themes: 1) experiences with current patient education, 2) expectations of AR in patient education, 3) opportunities and limitations of AR, and 4) out-of-hospital use of an AR application. Patients' expectations were predominantly positive regarding improving patients' understanding of their medical situation and doctor-patient communication. Discusssion: This study suggests that patients with unruptured intracranial aneurysms are open to receive patient education regarding their disease with AR. Patients expect that AR models can help patients with intra-cranial aneurysms better understand their disease, treatment options and risks. Additionally, patients expect AR could improve doctor-patient communication.
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Affiliation(s)
- Julie Urlings
- Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, Netherlands
- 3D Lab Radboudumc, Radboud University Medical Centre, Nijmegen, Netherlands
- Department of Medical Imaging, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Inger Abma
- IQ Healthcare, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - René Aquarius
- Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Marlien Aalbers
- Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Ronald Bartels
- Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Thomas Maal
- 3D Lab Radboudumc, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Dylan Henssen
- Department of Medical Imaging, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Jeroen Boogaarts
- Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, Netherlands
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Kuramochi I, Oga K, Iwayama T, Miyawaki Y, Ishihara T, Kobayashi S, Yoshimasu H. One-day psychosocial education program for people with epilepsy: A continuation study of the "Epi-school". Heliyon 2023; 9:e19311. [PMID: 37654450 PMCID: PMC10465952 DOI: 10.1016/j.heliyon.2023.e19311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 08/07/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023] Open
Abstract
Psychosocial education programs for people with epilepsy (PWE) can improve epilepsy knowledge and quality of life (QOL), whereas the availability of these programs is limited in Japan compared to other developed countries. This study evaluated the feasibility and effectiveness of a one-day group psychosocial education program named the "one-day Epi-school" for PWE and their relatives. The previous program (Epi-school) required consistent participation in three sessions, resulting in problems with program continuation rates, with 45.5% of PWE completing the program. Therefore, the "one-day Epi-school" was designed to provide information about epilepsy and address psychosocial issues related to coexisting epilepsy symptoms, such as self-stigma and self-esteem, while allowing participants to accomplish these programs within a single day. The study recruited a sample of 32 PWE and their relatives from a psychiatric clinic. They completed assessments of knowledge, self-stigma, self-esteem, and quality of life before and after the program. The results exhibited a significant increase in epilepsy knowledge after the intervention for PWE and their relatives. However, we could not identify other significant changes. The participation completion rate was 100%. The post-participation questionnaire proved beneficial to interact with other PWE. The study suggests that a single intervention, e.g., the one-day Epi-school, may be insufficient for enhancing other factors, yet it can be an adequate opportunity for learning and interacting. It is also necessary to implement future studies with larger sample sizes, a control group, and prolonged follow-up periods for the program's value and validity.
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Affiliation(s)
- Izumi Kuramochi
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-0844, Japan
- Department of Epileptology, Mara Hospital, Epilepsy Center Bethel, Bielefeld University, Maraweg 21, 33617, Bielefeld, Germany
| | - Koko Oga
- Department of Nursing, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-0844, Japan
| | - Takayuki Iwayama
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-0844, Japan
- Department of Psychology, Showa Women's University, 1 Chome-7-57 Taishido, Setagaya, Tokyo, 154-8533, Japan
| | - Yuko Miyawaki
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-0844, Japan
| | - Tomoki Ishihara
- Department of Pharmacy, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-0844, Japan
| | - Sayaka Kobayashi
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-0844, Japan
| | - Haruo Yoshimasu
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-0844, Japan
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Hatzl J, Hartmann N, Böckler D, Henning D, Peters A, Meisenbacher K, Uhl C. "Mixed Reality" in patient education prior to abdominal aortic aneurysm repair. VASA 2023; 52:160-168. [PMID: 36891667 DOI: 10.1024/0301-1526/a001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Background: To investigate the usability of Mixed-Reality (MR) during patient education in patients scheduled for abdominal aortic aneurysm (AAA) repair. Patients and methods: Consecutive patients scheduled for elective AAA repair were block-randomized in either the Mixed-Reality group (MR group) or the conventional group (control group). Patients of both groups were educated about open and endovascular repair of their respective AAA. The MR group was educated using a head-mounted display (HMD) demonstrating a three-dimensional virtual reconstruction of the respective patient's vascular anatomy. The control group was educated using a conventional two-dimensional monitor to display the patient's vasculature. Outcomes were informational gain as well as patient satisfaction with the educational process. (DRKS-ID: DRKS00025174). Results: 50 patients were included with 25 patients in either group. Both groups demonstrated improvements in scores in the Informational Gain Questionnaire (IGQ) when comparing pre- and post-education scores. (MR group: 6.5 points (±1.8) versus 7.9 points (±1.5); Control group: 6.2 points (±1.8) versus 7.6 points (±1.6); p<0.01) There was no significant difference between the MR group and the control group either in informational gain (MR group: 1.4±1.8; Control group: 1.4±1.8; p=0.5) nor in patient satisfaction scores (MR group: mean 18.3 of maximum 21 points (±3.7); Control group: mean 17 of 21 points (±3.6); p=0.1) Multiple regression revealed no correlation between the use of MR and informational gain or patient satisfaction. Usability of the system was rated high, and patients' subjective assessment of MR was positive. Conclusions: The use of MR in patient education of AAA patients scheduled for elective repair is feasible. While patients reported positively on the use of MR in education, similar levels of informational gain and patient satisfaction can be achieved with MR and conventional methods.
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Affiliation(s)
- Johannes Hatzl
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Niklas Hartmann
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Dittmar Böckler
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Daniel Henning
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Andreas Peters
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Katrin Meisenbacher
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Christian Uhl
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
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Berger MF, Winter R, Tuca AC, Michelitsch B, Schenkenfelder B, Hartmann R, Giretzlehner M, Reishofer G, Kamolz LP, Lumenta DB. Workflow assessment of an augmented reality application for planning of perforator flaps in plastic reconstructive surgery: Game or game changer? Digit Health 2023; 9:20552076231173554. [PMID: 37179745 PMCID: PMC10170605 DOI: 10.1177/20552076231173554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/14/2023] [Indexed: 05/15/2023] Open
Abstract
Objective In contrast to the rising amount of financial investments for research and development in medical technology worldwide is the lack of usability and clinical readiness of the produced systems. We evaluated an augmented reality (AR) setup under development for preoperative perforator vessel mapping for elective autologous breast reconstruction. Methods In this grant-supported research pilot, we used magnetic resonance angiography data (MR-A) of the trunk to superimpose the scans on the corresponding patients with hands-free AR goggles to identify regions-of-interest for surgical planning. Perforator location was assessed using MR-A imaging (MR-A projection) and Doppler ultrasound data (3D distance) and confirmed intraoperatively in all cases. We evaluated usability (System Usability Scale, SUS), data transfer load and documented personnel hours for software development, correlation of image data, as well as processing duration to clinical readiness (time from MR-A to AR projections per scan). Results All perforator locations were confirmed intraoperatively, and we found a strong correlation between MR-A projection and 3D distance measurements (Spearman r = 0.894). The overall usability (SUS) was 67 ± 10 (=moderate to good). The presented setup for AR projections took 173 min to clinical readiness (=availability on AR device per patient). Conclusion In this pilot, we calculated development investments based on project-approved grant-funded personnel hours with a moderate to good usability outcome resulting from some limitations: assessment was based on one-time testing with no previous training, a time lag of AR visualizations on the body and difficulties in spatial AR orientation. The use of AR systems can provide new opportunities for future surgical planning, but has more potential for educational (e.g., patient information) or training purposes of medical under- and postgraduates (spatial recognition of imaging data associated with anatomical structures and operative planning). We expect future usability improvements with refined user interfaces, faster AR hardware and artificial intelligence-enhanced visualization techniques.
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Affiliation(s)
- Matthias Fabian Berger
- Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Raimund Winter
- Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Alexandru-Cristian Tuca
- Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Birgit Michelitsch
- Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | | | | | | | - Gernot Reishofer
- Radiology Lab, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Lars-Peter Kamolz
- Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - David Benjamin Lumenta
- Research Unit for Digital Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
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Dinh A, Tseng E, Yin AL, Estrin D, Greenwald P, Fortenko A. Perceptions of Augmented Reality in Remote Medical Care: Interview Study of Emergency Telemedicine Providers (Preprint). JMIR Form Res 2022; 7:e45211. [PMID: 36976628 PMCID: PMC10131657 DOI: 10.2196/45211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Augmented reality (AR) and virtual reality (VR) have increasingly appeared in the medical literature in the past decade, with AR recently being studied for its potential role in remote health care delivery and communication. Recent literature describes AR's implementation in real-time telemedicine contexts across multiple specialties and settings, with remote emergency services in particular using AR to enhance disaster support and simulation education. Despite the introduction of AR in the medical literature and its potential to shape the future of remote medical services, studies have yet to investigate the perspectives of telemedicine providers regarding this novel technology. OBJECTIVE This study aimed to understand the applications and challenges of AR in telemedicine anticipated by emergency medicine providers with a range of experiences in using telemedicine and AR or VR technology. METHODS Across 10 academic medical institutions, 21 emergency medicine providers with variable exposures to telemedicine and AR or VR technology were recruited for semistructured interviews via snowball sampling. The interview questions focused on various potential uses of AR, anticipated obstacles that prevent its implementation in the telemedicine area, and how providers and patients might respond to its introduction. We included video demonstrations of a prototype using AR during the interviews to elicit more informed and complete insights regarding AR's potential in remote health care. Interviews were transcribed and analyzed via thematic coding. RESULTS Our study identified 2 major areas of use for AR in telemedicine. First, AR is perceived to facilitate information gathering by enhancing observational tasks such as visual examination and granting simultaneous access to data and remote experts. Second, AR is anticipated to supplement distance learning of both minor and major procedures and nonprocedural skills such as cue recognition and empathy for patients and trainees. AR may also supplement long-distance education programs and thereby support less specialized medical facilities. However, the addition of AR may exacerbate the preexisting financial, structural, and literacy barriers to telemedicine. Providers seek value demonstrated by extensive research on the clinical outcome, satisfaction, and financial benefits of AR. They also seek institutional support and early training before adopting novel tools such as AR. Although an overall mixed reception is anticipated, consumer adoption and awareness are key components in AR's adoption. CONCLUSIONS AR has the potential to enhance the ability to gather observational and medical information, which would serve a diverse set of applications in remote health care delivery and education. However, AR faces obstacles similar to those faced by the current telemedicine technology, such as lack of access, infrastructure, and familiarity. This paper discusses the potential areas of investigation that would inform future studies and approaches to implementing AR in telemedicine.
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Affiliation(s)
- Alana Dinh
- Medical College, Weill Cornell Medicine, New York, NY, United States
| | - Emily Tseng
- Department of Information Science, Cornell Tech, New York, NY, United States
| | - Andrew Lukas Yin
- Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Deborah Estrin
- Department of Computer Science, Cornell Tech, New York, NY, United States
| | - Peter Greenwald
- Emergency Medicine, NewYork-Presbyterian Hospital, New York, NY, United States
| | - Alexander Fortenko
- Emergency Medicine, NewYork-Presbyterian Hospital, New York, NY, United States
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14
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Grad P, Przeklasa-Bierowiec AM, Malinowski KP, Witowski J, Proniewska K, Tatoń G. Application of HoloLens-based augmented reality and three-dimensional printed anatomical tooth reference models in dental education. ANATOMICAL SCIENCES EDUCATION 2022. [PMID: 36524288 DOI: 10.1002/ase.2241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Tooth anatomy is fundamental knowledge used in everyday dental practice to reconstruct the occlusal surface during cavity fillings. The main objective of this project was to evaluate the suitability of two types of anatomical tooth reference models used to support reconstruction of the occlusal anatomy of the teeth: (1) a three-dimensional (3D)-printed model and (2) a model displayed in augmented reality (AR) using Microsoft HoloLens. The secondary objective was to evaluate three aspects impacting the outcome: clinical experience, comfort of work, and other variables. The tertiary objective was to evaluate the usefulness of AR in dental education. Anatomical models of crowns of three different molars were made using cone beam computed tomography image segmentation, printed with a stereolithographic 3D-printer, and then displayed in the HoloLens. Each participant reconstructed the occlusal anatomy of three teeth. One without any reference materials and two with an anatomical reference model, either 3D-printed or holographic. The reconstruction work was followed by the completion of an evaluation questionnaire. The maximum Hausdorff distances (Hmax) between the superimposed images of the specimens after the procedures and the anatomical models were then calculated. The results showed that the most accurate but slowest reconstruction was achieved with the use of 3D-printed reference models and that the results were not affected by other aspects considered. For this method, the Hmax was observed to be 630 μm (p = 0.004). It was concluded that while AR models can be helpful in dental anatomy education, they are not suitable replacements for physical models.
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Affiliation(s)
- Piotr Grad
- Department of Integrated Dentistry, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Anna M Przeklasa-Bierowiec
- Department of Integrated Dentistry, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof P Malinowski
- Department of Bioinformatics and Telemedicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Jan Witowski
- Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Klaudia Proniewska
- Department of Bioinformatics and Telemedicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Grzegorz Tatoń
- Department of Biophysics, Chair of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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