Use of extended reality in sleep health, medicine, and research: a scoping review

Assessing the knowledge, attitude and perception of Extended Reality (XR) technology in Pakistan's Healthcare community in an era of Artificial Intelligence

BACKGROUND AND OBJECTIVES

The Extended Reality (XR) technology was established by combining elements of Virtual Reality and Augmented Reality, offering users the advantage of working in a virtual environment. The study aimed to evaluate medical professionals' and students' knowledge, attitudes, and practices regarding using XR technology in Pakistan's healthcare system and identify its benefits, drawbacks, and implications for the system's future.

METHODOLOGY

A cross-sectional study was executed by circulating a self-structured online questionnaire among the Medical Community across Major Cities of Pakistan using various social media platforms as available sampling. The sample size was calculated to be 385 using RAOSOFT. Cronbach's alpha was calculated as 0.74. The Exploratory Factor Analysis (EFA) conducted on the dataset was validated using the Kaiser-Meyer-Olkin (KMO) measure and Bartlett's Test of Sphericity. The KMO value of 0.752 indicates adequate sampling, and Bartlett's Test was significant (χ2 (435) = 2809.772, p < 0.001), confirming the suitability of the data for factor analysis. Statistical analysis was done using SPSS-25, and data description was done as frequency and percentage. Pearson correlation and regression analysis kept p-value < 0.05% significant.

RESULTS

Approximately 54.8% of 406 participants conveyed their familiarity with XR technologies. The majority of participants (83.8%) believed that using XR technology effectively enhanced medical education and patient care in Pakistan. Regarding clinical outcomes, 70.8% believed XR improved the efficiency of procedures and 52.8% agreed XR would lead to more device-dependent systems and eradicating human error (32.4%). Major barriers to XR integration included ethical and privacy issues (63.9%), lack of technological advancements in Pakistan (70%), and lack of ample knowledge and training of XR among health care professionals (45.8%). Hypothesis testing revealed a low positive but significant correlation between the use of AI-based healthcare systems and the increasing speed and accuracy of procedures (r = 0.342, p < 0.001), supporting Hypothesis 1. Similarly, a very low positive yet significant correlation was observed between the augmentation of diagnostic and surgical procedures and addressing data security and ethical issues for implementing XR (r = 0.298, p < 0.001), supporting Hypothesis 2. Lastly, a correlation between the mean Attitude (MA) score and the mean Perception (MP) score was found to be moderately positive and significant (r = 0.356, p < 0.001). Hence, the hypothesis 3 was supported.

CONCLUSION

XR technology has the potential to enhance medical education and patient care in Pakistan, but its adoption faces significant challenges, including ethical concerns, technological gaps, and inadequate training. The study's findings highlight the need to address these issues to maximize the benefits of XR in healthcare.

Extended Reality Head-Mounted Displays Are Likely to Pose a Significant Risk in Medical Settings While Current Classification Remains as Non-Critical

Extended reality (XR) devices, including virtual and augmented reality head-mounted displays (HMDs), are increasingly utilised within healthcare to provide clinical interventions and education. Currently, XR devices are utilised to assist in reducing pain and improving psychological outcomes for immunocompromised patients in intensive care units, palliative care environments and surgical theatres. However, there is a paucity of research on the risks of infection from such devices in healthcare settings. Identify existing literature providing insights into the infection control risk XR HMDs pose within healthcare facilities and the efficacy of current infection control and cleaning procedures. Three databases (PubMed, Embase and CINAHL) in addition to Google Scholar were systematically searched. A total of seven studies were identified for this review. Microorganisms, including pathogenic bacteria (e.g., Staphylococcus aureus and Pseudomonas aeruginosa), were found to be present on XR HMDs. Published cleaning and infection control protocols designed to disinfect XR HMDs and protect users were heterogeneous in nature. Current cleaning protocols displayed varying levels of efficacy with microbial load affected by multiple factors, including time in use, number of users and XR HMD design features. In healthcare settings, fitting XR HMDs harbouring microorganisms near biological and mucosal entry points presents an infection control risk. An urgent revision of the Spaulding classification is required to ensure flexibility that allows for these devices to be reclassified from 'Non-critical' to 'Semi-Critical' depending on the healthcare setting and patient population (surgery, immunocompromised, burns, etc.). This review identified evidence supporting the presence of microorganisms on XR HMDs. Due to the potential for HMDs to contact mucosal entry points, devices must be re-considered within the Spaulding classification as 'Semi-critical'. The existence of microbial contaminated XR HMDs in high-risk medical settings such as operating wards, intensive care units, emergency departments, labour and delivery wards and clinical areas with immunosuppressed patients requires urgent attention. Public health authorities have a duty of care to develop revised guidelines or new recommendations to ensure efficient sanitation of such devices.