Recommendations for Methodology of Virtual Reality Clinical Trials in Health Care by an International Working Group: Iterative Study (Preprint)

Birckhead, Brandon; Khalil, Carine; Liu, Xiaoyu; Conovitz, Samuel; Rizzo, Albert; Danovitch, Itai; Bullock, Kim; Spiegel, Brennan M.

doi:10.2196/preprints.11973

Cited by 4 publications

(2 citation statements)

References 63 publications

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“…This study showed the importance of thorough implementation. However, generally, the emphasis on systematic, multi-level implementation is lacking concerning VR's application in healthcare (Levac et al, 2015;Birckhead et al, 2019;Kouijzer et al, 2023). The current study provides valuable initial insights into important aspects of the introduction of VR technology into treatment practice.…”

Section: Comparison With Prior Workmentioning

confidence: 99%

The introduction of virtual reality in forensic mental healthcare – an interview study on the first impressions of patients and healthcare providers regarding VR in treatment

Kouijzer,

Kip,

Kelders

et al. 2024

Front. Psychol.

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BackgroundRecognizing the potential of Virtual Reality (VR) as a powerful technology to support behavior change, the careful introduction of this technology into treatment settings is essential. This is especially important in vulnerable populations like forensic psychiatric patients. This study aims to gain insight from the impressions of both patients and healthcare providers concerning the integration of VR in practice. The study aims to contribute valuable information that guides the introduction of VR technology, ensuring its optimal use in the complex context of forensic mental healthcare.MethodsSemi-structured interviews were conducted with healthcare providers (n = 10) working at forensic outpatient clinics and forensic psychiatric patients (n = 8). All participants experienced VR before the interview. Inductive thematic analysis was employed for analyzing the interview data.ResultsPatients valued the unique opportunity to simulate personal experiences in VR scenarios and reflect on them with healthcare providers. In addition to positive first impressions, areas for improvement were identified, including the wish for enhanced realism and reduced physical discomfort while immersed in VR. Finally, important factors contributing to the successful introduction of VR were identified. For example, taking into account psychological distress experienced by patients or supporting healthcare providers with implementation resources.ConclusionThe integration of VR into forensic mental healthcare holds great potential for behavior change. However, its immersive characteristics also increase the chance of amplifying psychological distress. This emphasizes the need for caution when using VR– especially when a vulnerable patient group is subjected to triggering scenarios. This study advocates for a gradual introduction of the technology and provides valuable insights into essential elements for this introduction in clinical practice. It highlights that even the initial step of integrating VR into practice – the introduction phase – demands careful planning and a personalized approach. This underscores the need for ongoing refinement and a systematic approach to the overall implementation of VR. These efforts are crucial to fully realize its potential in clinical practice.

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Section: Comparison With Prior Workmentioning

confidence: 99%

The introduction of virtual reality in forensic mental healthcare – an interview study on the first impressions of patients and healthcare providers regarding VR in treatment

Kouijzer,

Kip,

Kelders

et al. 2024

Front. Psychol.

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“…Thus, users can be immersed in VR simulations and interact with virtual content for human performance measurement and training, and by extension for the clinical purposes of assessment and intervention. This "Ultimate Skinner Box" perspective makes VR technology well-matched to the requirements of various experimental and clinical objectives and this provides conceptual support for its use in a wide variety of healthcare contexts (Maples-Keller et al, 2017;Rizzo and Koenig, 2017;Birckhead et al,. 2019;Hoffman et al, 2019;Powers and Rothbaum, 2019;Riva et al, 2019;Slater et al, 2019;Schweitzer and Rizzo, 2022;Lacy et al, 2023;Rizzo et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Normative performance data on visual attention in neurotypical children: virtual reality assessment of cognitive and psychomotor development

Goh,

Ma,

Rizzo

2024

Front. Virtual Real.

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Introduction: Virtual Reality (VR) is revolutionizing healthcare research and practice by offering innovative methodologies across various clinical conditions. Advances in VR technology enable the creation of controllable, multisensory 3D environments, making it an appealing tool for capturing and quantifying behavior in realistic scenarios. This paper details the application of VR as a tool for neurocognitive evaluation, specifically in attention process assessment, an area of relevance for informing the diagnosis of childhood health conditions such as Attention Deficit Hyperactivity Disorder (ADHD).Methods: The data presented focuses on attention performance results from a large sample (n = 837) of neurotypical male and female children (ages 6–13) tested on a visual continuous performance task, administered within an immersive VR classroom environment. This data was collected to create a normative baseline database for use to inform comparisons with the performances of children with ADHD to support diagnostic decision-making in this area.Results: Results indicate systematic improvements on most metrics across the age span, and sex differences are noted on key variables thought to reflect differential measures of hyperactivity and inattention in children with ADHD. Results support VR technology as a safe and viable option for testing attention processes in children, under stimulus conditions that closely mimic ecologically relevant challenges found in everyday life.Discussion: In response to these stimulus conditions, VR can support advanced methods for capturing and quantifying users’ behavioral responses. VR offers a more systematic and objective approach for clinical assessment and intervention and provides conceptual support for its use in a wide variety of healthcare contexts.

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Recommendations for the Design and Implementation of Virtual Reality for Acquired Brain Injury Rehabilitation: Systematic Review (Preprint)

Brassel¹,

Power²,

Campbell³

et al. 2020

Preprint

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BACKGROUND Virtual reality (VR) is increasingly being used for the assessment and treatment of impairments arising from acquired brain injuries (ABIs) due to perceived benefits over traditional methods. However, no tailored options exist for the design and implementation of VR for ABI rehabilitation and, more specifically, traumatic brain injury (TBI) rehabilitation. In addition, the evidence base lacks systematic reviews of immersive VR use for TBI rehabilitation. Recommendations for this population are important because of the many complex and diverse impairments that individuals can experience. OBJECTIVE This study aims to conduct a two-part systematic review to identify and synthesize existing recommendations for designing and implementing therapeutic VR for ABI rehabilitation, including TBI, and to identify current evidence for using immersive VR for TBI assessment and treatment and to map the degree to which this literature includes recommendations for VR design and implementation. METHODS This review was guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). A comprehensive search of 11 databases and gray literature was conducted in August 2019 and repeated in June 2020. Studies were included if they met relevant search terms, were peer-reviewed, were written in English, and were published between 2009 and 2020. Studies were reviewed to determine the level of evidence and methodological quality. For the first part, qualitative data were synthesized and categorized via meta-synthesis. For the second part, findings were analyzed and synthesized descriptively owing to the heterogeneity of data extracted from the included studies. RESULTS In the first part, a total of 14 papers met the inclusion criteria. Recommendations for VR design and implementation were not specific to TBI but rather to stroke or ABI rehabilitation more broadly. The synthesis and analysis of data resulted in three key phases and nine categories of recommendations for designing and implementing VR for ABI rehabilitation. In the second part, 5 studies met the inclusion criteria. A total of 2 studies reported on VR for assessment and three for treatment. Studies were varied in terms of therapeutic targets, VR tasks, and outcome measures. VR was used to assess or treat impairments in cognition, balance, and anxiety, with positive outcomes. However, the levels of evidence, methodological quality, and inclusion of recommendations for VR design and implementation were poor. CONCLUSIONS There is limited research on the use of immersive VR for TBI rehabilitation. Few studies have been conducted, and there is limited inclusion of recommendations for therapeutic VR design and implementation. Future research in ABI rehabilitation should consider a stepwise approach to VR development, from early co-design studies with end users to larger controlled trials. A list of recommendations is offered to provide guidance and a more consistent model to advance clinical research in this area. CLINICALTRIAL

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Recommendations for Methodology of Virtual Reality Clinical Trials in Health Care by an International Working Group: Iterative Study (Preprint)

Abstract: Background: Therapeutic virtual reality (VR) has emerged as an efficacious treatment modality

Cited by 4 publications

References 63 publications

The introduction of virtual reality in forensic mental healthcare – an interview study on the first impressions of patients and healthcare providers regarding VR in treatment

The introduction of virtual reality in forensic mental healthcare – an interview study on the first impressions of patients and healthcare providers regarding VR in treatment

Normative performance data on visual attention in neurotypical children: virtual reality assessment of cognitive and psychomotor development

Recommendations for the Design and Implementation of Virtual Reality for Acquired Brain Injury Rehabilitation: Systematic Review (Preprint)

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