Background Virtual reality (VR) technology provides an immersive environment that enables users to have modified experiences of reality. VR is increasingly used to manage patients with pain, disability, obesity, neurologic dysfunction, anxiety, and depression. However, public opinion regarding the use of VR in health care has not been explored. Understanding public opinion of VR is critical to ensuring effective implementation of this emerging technology. Objective This study aimed to examine public opinion about health care VR using social listening, a method that allows for the exploration of unfiltered views of topics discussed on social media and online forums. Methods In March 2016, NBC News produced a video depicting the use of VR for patient care. The video was repackaged by NowThis, a social media news website, and distributed on Facebook by Upworthy, a news aggregator, yielding 4.3 million views and 2401 comments. We used Microsoft Excel Power Query and ATLAS.ti software (version 7.5, Scientific Software Development) to analyze the comments using content analysis and categorized the comments around first-, second-, and third-order concepts. We determined self-identified gender from the user’s Facebook page and performed sentiment analysis of the language to analyze whether the perception of VR differed by gender using a Pearson’s chi-square test. Results Out of the 1614 analyzable comments, 1021 (63.26%) were attributed to female Facebook users, 572 (35.44%) to male users, and 21 (1.30%) to users of unknown gender. There were 1197 comments coded as expressing a positive perception about VR (74.16%), 251 coded as expressing a negative perception and/or concern (15.56%), and 560 coded as neutral (34.70%). Informants identified 20 use cases for VR in health care, including the use of VR for pain and stress reduction; bed-bound individuals; women during labor; and patients undergoing chemotherapy, dialysis, radiation, or imaging procedures. Negative comments expressed concerns about radiation, infection risk, motion sickness, and the ubiquity of and overall dependence on technology. There was a statistically significant association between the language valence of the Facebook post and the gender of the Facebook user; men were more likely to post negative perceptions about the use of VR for health care, whereas women were more likely to post positive perceptions ( P <.001). Conclusions Most informants expressed positive perceptions about the use of VR in a wide range of health care settings. However, many expressed concerns that should be acknowledged and addressed as health care VR continues to evolve. Our results provide guidance in determining where further research on the use of VR in patient care is needed, and offer a formal opportunity for public opinion to shape the VR research agenda.

Although intravenous racemic ketamine has rapid antidepressant properties, it is not approved for depression treatment. 1 However, the US Food and Drug Administration has approved intranasal esketamine for treatment-resistant depression. 1 Correia-Melo et al 2 treated 63 participants with intravenous ketamine or esketamine and observed that esketamine was noninferior to ketamine. A recent meta-analysis suggested that intravenous ketamine was more effective, 3 but the only head-to-head trial included was from Correia-Melo et al, 2 rendering interpretation difficult. To our knowledge, no multidose, head-to-head comparisons of these treatments have been reported.The Yale Interventional Psychiatry Service (IPS) provides both intravenous ketamine (0.5 mg/kg over 40 minutes) and intranasal esketamine (56 or 84 mg). Patients receive similar care with comparable protocols in the same physical space. We analyzed Yale IPS clinical data to evaluate these treatments in a clinical setting.Methods | For this comparative analysis, we reviewed retrospective data for all Yale IPS patients receiving intravenous ketamine or intranasal esketamine between September 2016 and April 2021 (eMethods in the Supplement). The Yale Institutional Review Board approved this analysis of existing clinical data and waived informed consent per the Common Rule. The analysis followed the ISPOR reporting guideline.Results | Of 210 included patients, 129 (61.4%) received intravenous ketamine and 81 (38.6%) received intranasal esketamine. There were no differences in baseline demographic factors (Table ). The estimated group difference in Montgomery-Åsberg Depression Rating Scale (MADRS) score by treatment end (primary outcome) was 2.15 (95% CI, −0.06 to 4.37; P = .06). Estimated group differences in Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) scores after full treatment course and MADRS and QIDS-SR scores after the first 6 treatments (secondary outcomes) were 1.59 (95% CI, 0.24-2.94; P = .02), 2.49 (95% CI, 0.01-4.98; P < .05), and 1.64 (0.08-3.19; P = .04), respectively, all favoring intravenous ketamine (Figure). Other models produced similar results. There were no group differences in response rates (37.8% [95% CI, 30.0%-46.3%] vs 36.0% [95% CI, 25.9%-47.5%]) or remission (29.6% [95% CI, 22.5%-37.9%] vs 24.0% [95% CI, 15.6%-35.0%]) for ketamine vs esketamine, respectively.

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BACKGROUND Virtual reality (VR) technology provides an immersive environment that enables users to have modified experiences of reality. VR is increasingly used to manage patients with pain, disability, obesity, neurologic dysfunction, anxiety, and depression. However, public opinion regarding the use of VR in health care has not been explored. Understanding public opinion of VR is critical to ensuring effective implementation of this emerging technology. OBJECTIVE This study aimed to examine public opinion about health care VR using social listening, a method that allows for the exploration of unfiltered views of topics discussed on social media and online forums. METHODS In March 2016, NBC News produced a video depicting the use of VR for patient care. The video was repackaged by NowThis, a social media news website, and distributed on Facebook by Upworthy, a news aggregator, yielding 4.3 million views and 2401 comments. We used Microsoft Excel Power Query and ATLAS.ti software (version 7.5, Scientific Software Development) to analyze the comments using content analysis and categorized the comments around first-, second-, and third-order concepts. We determined self-identified gender from the user’s Facebook page and performed sentiment analysis of the language to analyze whether the perception of VR differed by gender using a Pearson’s chi-square test. RESULTS Out of the 1614 analyzable comments, 1021 (63.26%) were attributed to female Facebook users, 572 (35.44%) to male users, and 21 (1.30%) to users of unknown gender. There were 1197 comments coded as expressing a positive perception about VR (74.16%), 251 coded as expressing a negative perception and/or concern (15.56%), and 560 coded as neutral (34.70%). Informants identified 20 use cases for VR in health care, including the use of VR for pain and stress reduction; bed-bound individuals; women during labor; and patients undergoing chemotherapy, dialysis, radiation, or imaging procedures. Negative comments expressed concerns about radiation, infection risk, motion sickness, and the ubiquity of and overall dependence on technology. There was a statistically significant association between the language valence of the Facebook post and the gender of the Facebook user; men were more likely to post negative perceptions about the use of VR for health care, whereas women were more likely to post positive perceptions (P<.001). CONCLUSIONS Most informants expressed positive perceptions about the use of VR in a wide range of health care settings. However, many expressed concerns that should be acknowledged and addressed as health care VR continues to evolve. Our results provide guidance in determining where further research on the use of VR in patient care is needed, and offer a formal opportunity for public opinion to shape the VR research agenda.