Virtual reality for patient informed consent in skull base tumors and intracranial vascular pathologies: A pilot study

IF 1.9 3区 医学 Q3 CLINICAL NEUROLOGY Acta Neurochirurgica Pub Date : 2024-11-15 DOI:10.1007/s00701-024-06355-w
Emilia Westarp, Attill Saemann, Marek Zelechovski, Balazs Faludi, Philippe Cattin, Jehuda Soleman, Raphael Guzman
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Abstract

Purpose

With the growing demand for shared decision-making and patient-centered care, optimal informed consent (IC) has gained relevance. Virtual reality (VR) has seen significant technological advancements, and its medical applications currently include surgical planning and medical education. This pilot study investigates the feasibility of VR-enhanced informed consent (VR-IC) in neurosurgery to improve preoperative IC and patient satisfaction.

Methods

We included patients aged 18 to 75 years who were scheduled for skull base meningioma or brain aneurysm surgery between May and December 2023. Exclusion criteria were visual/auditory impairments and severe cognitive/psychiatric disorders. Patients received standard IC followed by VR-IC using patient-specific VR models of their pathology. After an initial demonstration by the surgeon, the patients used the VR station independently. A questionnaire with 18 questions on a 5-point Likert scale assessed the subjective impression of VR-IC.

Results

Ten patients participated in the study, with six (60%) undergoing aneurysm clipping and four (40%) undergoing skull base meningioma resection. The mean age of the participants was 58 years (± 15, range 27 to 75 years), with four female patients (40%). Patients overall rated the VR-informed consent (VR-IC) positively with a mean of 4.22 (± 0.84). There was a better understanding of their pathology (mean 4.30 ± 0.92) and the planned procedure (mean 3.95 ± 1.04). Trust in the surgeon was rated with a mean of 3.47 (± 0.94). Only minimal side effects from the VR experience including dizziness or discomfort were noted (mean 4.60 ± 0.22). None of the participants dropped out of the study.

Conclusion

VR-enhanced informed consent is feasible and improves patient understanding and satisfaction without significant side effects. These findings will guide the planning of a randomized controlled trial to validate the benefits of VR-IC in neurosurgery further.

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虚拟现实技术用于颅底肿瘤和颅内血管病变的患者知情同意:试点研究
目的 随着对共同决策和以患者为中心的护理的需求日益增长,最佳知情同意(IC)已变得越来越重要。虚拟现实(VR)技术取得了长足的进步,其医疗应用目前包括手术规划和医学教育。本试验性研究调查了 VR 增强知情同意(VR-IC)在神经外科手术中的可行性,以改善术前知情同意和患者满意度。方法我们纳入了年龄在 18 岁至 75 岁之间、计划在 2023 年 5 月至 12 月期间接受颅底脑膜瘤或脑动脉瘤手术的患者。排除标准为视觉/听觉障碍和严重认知/精神障碍。患者在接受标准 IC 治疗后,将使用患者特定的病理 VR 模型进行 VR-IC 治疗。在外科医生进行初步演示后,患者独立使用 VR 站。结果10名患者参加了这项研究,其中6人(60%)接受了动脉瘤切除术,4人(40%)接受了颅底脑膜瘤切除术。参与者的平均年龄为 58 岁(± 15,年龄范围为 27 岁至 75 岁),其中有四名女性患者(占 40%)。患者对虚拟现实知情同意书(VR-IC)的总体评价是积极的,平均为 4.22(± 0.84)分。他们对自己的病理(平均值为 4.30 ± 0.92)和计划的手术(平均值为 3.95 ± 1.04)有了更好的了解。对外科医生的信任度平均为 3.47 (± 0.94)。VR 体验只产生了极小的副作用,包括头晕或不适(平均值为 4.60 ± 0.22)。结论 VR 增强知情同意是可行的,能提高患者的理解力和满意度,且无明显副作用。这些发现将为随机对照试验的规划提供指导,以进一步验证 VR-IC 在神经外科手术中的益处。
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来源期刊
Acta Neurochirurgica
Acta Neurochirurgica 医学-临床神经学
CiteScore
4.40
自引率
4.20%
发文量
342
审稿时长
1 months
期刊介绍: The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.
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