360-Degree Virtual Reality Consultation for the Structural Heart Disease Patient

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El metaverso es un mundo virtual, aún en proceso de desarrollo, que permite a las personas interactuar entre ellas, así como con objetos digitales de una forma más inmersiva. Esta innovadora herramienta aúna las tres principales tendencias tecnológicas: la telepresencia, el gemelo digital y la cadena de bloques. La telepresencia permite a las personas “reunirse” de manera virtual, aunque se encuentren en distintos lugares. El gemelo digital es el equivalente virtual y digital de un paciente, dispositivo médico o incluso de un hospital. Por último, la cadena de bloques puede ser utilizada por los pacientes para almacenar sus informes médicos personales de forma segura. En medicina, el metaverso podría tener distintas aplicaciones: (1) consultas médicas virtuales; (2) educación y formación médica; (3) educación del paciente; (4) investigación médica; (5) desarrollo de medicamentos; (6) terapia y apoyo; (7) medicina de laboratorio. El metaverso permitiría una atención sanitaria más personalizada, eficiente y accesible, mejorando así los resultados clínicos y reduciendo los costes de atención médica. No obstante, la implementación del metaverso en medicina y atención sanitaria requerirá una cuidadosa evaluación de los aspectos éticos y de privacidad, así como técnicos, sociales y jurídicos. En términos generales, el futuro del metaverso en el campo de la medicina parece prometedor, aunque es necesario desarrollar nuevas leyes que regulen específicamente el metaverso, con el fin de superar sus posibles inconvenientes.

Applications of the metaverse in medicine and healthcare

The metaverse is a virtual world that is being developed to allow people to interact with each other and with digital objects in a more immersive way. It involves the convergence of three major technological trends: telepresence, the digital twin, and blockchain. Telepresence is the ability of people to "be together" in a virtual way while not being close to each other. The digital twin is a virtual, digital equivalent of a patient, a medical device or even a hospital. Blockchain can be used by patients to keep their personal medical records secure. In medicine and healthcare, the metaverse could be used in several ways: (1) virtual medical consultations; (2) medical education and training; (3) patient education; (4) medical research; (5) drug development; (6) therapy and support; (7) laboratory medicine. The metaverse has the potential to enable more personalized, efficient, and accessible healthcare, improving patient outcomes and reducing healthcare costs. However, the implementation of the metaverse in medicine and healthcare will require careful consideration of ethical and privacy concerns, as well as social, technical and regulatory challenges. Overall, the future of the metaverse in healthcare looks bright, but new metaverse-specific laws should be created to help overcome any potential downsides.

Virtual Reality for Patient Education about Hypertension: A Randomized Pilot Study

BACKGROUND

Hypertension challenges arise in part from poor adherence due to inadequate patient education. VR offers immersive learning to improve hypertension knowledge.

OBJECTIVE

To compare VR education with traditional verbal education to improve hypertension knowledge.

METHODS

In this randomised trial, 182 patients with hypertension were assigned to receive either traditional physician-led education (n = 88) or VR education (n = 94) with equivalent content. The VR group experienced a 3D video using Oculus Quest 2 headsets. Knowledge was assessed post-intervention using a 29-item questionnaire. The primary outcome was the objective score. Subjective satisfaction and responder characteristics were secondary outcomes.

RESULTS

Median objective scores were significantly higher for VR (14, IQR 3) versus traditional education (10, IQR 5), p < 0.001, indicating superior hypertension knowledge acquisition with VR. Subjective satisfaction was high in both groups. Participants were categorized into low (first quartile) and medium-high (second to fourth quartiles) responders based on their scores. Low responders had a significantly higher prevalence of older women than medium-high responders (57% vs. 40% female, p = 0.024; 68 vs. 65 years), p = 0.036).

CONCLUSIONS

VR outperforms traditional education. Tailoring to groups such as older women can optimise learning.

Preoperative planning using virtual reality for percutaneous transseptal valve-in-valve transcatheter mitral valve replacement: a case report

Background

Virtual reality (VR) technology has been implemented as a pre-procedural planning tool for cardiovascular interventions to enable detailed evaluation of patient anatomy from different vantage points. Here, we employed a VR platform to preoperatively plan for percutaneous valve-in-valve transcatheter mitral replacement (ViV-TMVR) in a prohibitive surgical candidate.

Case summary

An 85-year-old male with a history of two prior sternotomies for bioprosthetic aortic valve (AV) and mitral valve (MV) 31 mm Medtronic Mosaic bioprosthesis presented with severe mitral regurgitation from a degenerative bioprosthetic MV. The patient was deemed a prohibitive surgical candidate for a third sternotomy and instead was recommended a percutaneous transseptal ViV-TMVR. An electrocardiogram-gated chest computed tomography (CT) provided a neo-left-ventricular outflow tract (neo-LVOT) of 1.89 cm2. This CT was reconstructed to create a 360° VR (360VR) model. A 29 mm SAPIEN three bioprosthetic valve, selected based on the already implanted MV, was placed inside the bioprosthetic MV and analysed in VR at different angles to ensure it would not obstruct the LVOT. The neo-LVOT measured in VR was 3.02 cm2, which would allow for sufficient blood flow without significant obstruction from the new SAPIEN three bioprosthetic valve. The patient tolerated the procedure well.

Discussion

This case demonstrates the utility of VR as a pre-procedural planning tool for interventional cardiology procedures. Preoperative planning in VR alleviated concerns regarding obstruction of the neo-LVOT and helped confirm safe implantation by clearly showing the three-dimensional spatial relationship between the implants and surrounding patient anatomy.

Does virtual reality in the perioperative setting for patient education improve understanding? A scoping review

Background

The potential uses of Virtual Reality (VR) to educate patients perioperatively are now an emerging field of research. The objective of this scoping review is to assess the extent of the literature on how immersive VR is being used perioperatively to specifically improve patient understanding of their pathology or procedure.

Methods

A systematic search was carried out with inclusion criteria; adults (≥18 years old); use of immersive VR; perioperative setting for patient education.

Results

Twelve studies were reviewed, the majority of which were unpowered, non-randomised experimental trials. VR was mainly used during procedure consent to show patients a 3D anatomical model of the relevant anatomy. Subjective and objective patient understanding was improved after exposure to VR.

Conclusions

Continuing advances in VR technology will make this option more accessible to health care settings in the future and further research in this arena should prioritise statistically powered, high quality study design.

Virtual reality as a patient education tool in healthcare: A scoping review

OBJECTIVE

To explore what is currently known about the use of virtual reality (VR) as a patient education tool in healthcare.

METHODS

Arksey and O'Malley's scoping review method and the PRISMA-ScR Checklist were employed. Four peer-reviewed databases were searched (Medline, Embase, PsychINFO, the Cochrane library). Pre-defined selection criteria identified 18 studies for inclusion. Results were synthesized using a narrative approach.

RESULTS

VR as an educational tool in healthcare is feasible and acceptable, and may improve patient's knowledge about their illness and satisfaction with treatment. Most studies used the Oculus VR glasses or headset, educated patients though the use of 3D 360° VR anatomical models, and were conducted with people affected with cancer. Opportunities exist for exploring unintended consequences, and the role of VR in educating populations with lower health literacy.

CONCLUSION

VR could assist in communicating medical information and knowledge to patients, but more research is needed, particularly to identify for whom and in what situations this method is most useful and to improve understanding about the potential unintended consequences.

PRACTICE IMPLICATIONS

Health professionals should consider using VR to educate their patients, and researchers can use this as a road map on how to address knowledge gaps in this field.